A suicide-prevention support service in Indian-administered Kashmir is a lifeline for people struggling with mental health issues. However, many in this conservative region are reluctant to seek help.
Mehfooz Ahmad*, 56, was struggling with the social stigma of his daughter eloping with her boyfriend days before she was arranged to be married to another man.
He became despondent and, over time, stopped meeting up with his friends and started having suicidal thoughts.
On a chilly evening in September, Ahmad locked the front door of his house and went up to his bedroom carrying a bottle of toxic zinc phosphide with the intention of ending his life.
However, he instead picked up his smartphone and searched "Zindagi," which means life in Hindi.
It's also the name of a suicide prevention helpline recently established by the Institute of Mental Health and Neurosciences (IMHANS) in Srinagar, the capital city of Indian-administered Kashmir.
"Hello! Can you help me?" Ahmad pleaded.
A young psychologist picked up his call, and they spoke for two hours until Ahmad finally calmed down.
"I built on protective factors by talking about the future of his younger daughter and son," recalled Zoya Mir, a clinical psychologist who heads the Zindagi project at the IMHANS.
"I also found his religious belief had given him a survival instinct. Hence, I exaggerated that until he calmed down," he told DW.
Breaking the stigma about suicide
In Muslim-majority Kashmir, suicide has a stigma attached to it, which experts say prevents people from seeking professional help for their mental health.
"There is no word equivalent to suicide in the Kashmiri language. That shows how rare the phenomenon was in our culture," said Dr Syed Mehvish Yawar, a psychiatrist associated with the Zindagi project
The helpline was established to end the stigma surrounding suicide and to encourage people to talk openly about suicide and to seek help, Yawar told DW.
According to the government's Crime Gazette for 2021, Indian-administered Kashmir recorded 586 suicide cases last year, and 472 in 2020.
The region has a higher suicide rate than other Indian states and recorded 2,612 deaths by suicide from 2010 to 2018. Nearly 290 people die every year by suicide according to figures from India's National Crime Records Bureau.
Some studies estimate that as many as 45% of the 7 million-strong population suffers from some kind of mental distress.
A 2016 report published by the international NGO ActionAid and the IMHANS found that mental disorders were particularly widespread among vulnerable groups.
The high rate of mental illness was mainly attributed to poor access to treatment, stigma, and at the root of it all, conflict.
Reaching out for help
But Yawar estimated that the Zindagi helpline had helped to prevent nearly 400 suicides after people called for counselling and psychological support.
The project entails a group of clinical psychologists, who are mostly young women, providing services to improve mental well-being, such as suicide prevention counselling, first aid, psychological support, distress management, and psychological crisis management.
Zindagi head Mir said the helpline gets calls mostly from adolescents and young people with low self-esteem. She said that many were vulnerable to suicide because the ongoing conflict in the region had adversely affected their mental health.
However, half of the calls received were related to heartbreak, financial distress in the family, failing marriages or failing to live up to parental expectations, she added.
An unhappy marriage
Mir recalled how a 32-year-old woman, Maria* from south Kashmir, had shouted at her, saying no one could understand the trauma she had been going through in her married life.
Despite marrying the love of her life, Maria had been sexually and physically abused by her husband for a long time and had been driven to attempt suicide, Mir said.
"Maria was rude to us and repeatedly shouting she wanted to kill herself to get rid of the pain," Mir said.
"We counselled her on how she can fight the trauma and remove toxicity from her relationship with her husband."
The next day Maria came to the IMHANS for counselling and said that she had made 16 earlier suicide attempts.
"Timely advice can prevent them from attempting suicide, but unfortunately, they mostly don't get that support from their family members or friends," explained clinical psychologist Masood Maqbool.
Maqbool added that the Zindagi helpline had prevented nearly 99% of callers from attempting suicide.
Mental health is widely misunderstood in Kashmir, which did not have a psychiatric hospital until 1989. Often relatives approach a faith healer but this can complicate the situation of people with mental health issues.
Traumatized healthcare workers
Though the healthcare workers at Zindagi have helped to prevent many suicides, their own mental health can also be adversely affected by having to deal with suicidal callers.
Days after Ahmad's suicide attempt was thwarted, police announced that a 52-year-old man had died after jumping into the River Jhelum in Srinagar.
"My heart sank, and I started crying after hearing the news, thinking it might be Ahmad," Mir said. "We broke the protocol and retrieved his phone number from our data to call him. [...] But fortunately, it was not him."
One psychologist, who also deals with suicidal callers, told DW on condition of anonymity that often counsellors wanted to be saviors, but a fear of failure often resulted in emotional trauma.
"The situation of a person, who is about to commit suicide, would give goosebumps to anyone," he said, adding that not knowing whether they would be able to help to save somebody was very stressful for psychologists and counsellors.
He said that one important means of dealing with the emotional burden was to talk to colleagues about one's own mental health issues.
Editor's note: If you are having suicidal thoughts or are thinking about hurting yourself, please seek professional help. You can find information on where to find such help, no matter where you are in the world, at www.befrienders.org
*Starred names have been changed to protect identities.