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For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions" /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="The ongoing turmoil in India’s north east is having repercussions beyond physical wounds. Nuzhat Khan and Zoya Hussain report on the trauma—and the dearth of mental health support plaguing Manipur On 3 May last year Esther Haokip, a 23 year old Kuki student, was inside her hostel when a violent mob attacked her university in Manipur, northeast India. She recalls that a mob of 40 men climbed the walls and entered the hostel premises, set vehicles on fire, and even pelted stones at windows before breaking down the main gate. Haokip, who currently lives with her relatives in Delhi, said that the girls in her hostel started hiding in groups in bathrooms as they heard the mob breaking the doors of their rooms. “Initially I thought that it hadn’t affected me,” she says. “But as time goes by it becomes more difficult to cope. I find myself having multiple breakdowns. I get scared when I hear people shouting.” It’s been one year since ethnic clashes erupted in the Indian state of Manipur—the start of a murderous civil war between the Meitei and Kuki communities that has engulfed the northeastern state, leaving at least 227 people dead and around 70 000 displaced. Thousands of people from both communities continue to languish in relief camps throughout the state: Manipur has at least 350 camps. The violence in the region has left women and children struggling to cope with psychological trauma, including depression, sleeplessness, panic attacks, and post-traumatic stress disorder (PTSD). The six decade long conflict in Manipur had already significantly affected the mental health of the region’s population, a 2020 study having estimated a 20% prevalence of mental health problems in adults before the most recent outbreak of violence.1 This figure is notably higher than the national average of 10.6%. The conflict’s …" /> <meta name="DC.Contributor" content="Nuzhat Khan" /> <meta name="DC.Contributor" content="Zoya Hussain" /> <meta name="article:published_time" content="2024-08-02" /> <meta name="article:section" content="Feature" /> <meta name="citation_title" content="Manipur’s mental health crisis, a year after violence" /> <meta name="citation_abstract" lang="en" scheme="teaser" content="<p>The ongoing turmoil in India’s north east is having repercussions beyond physical wounds. <b>Nuzhat Khan</b> and <b>Zoya Hussain</b> report on the trauma—and the dearth of mental health support plaguing Manipur</p>" /> <meta name="citation_journal_title" content="BMJ" /> <meta name="citation_publisher" content="British Medical Journal Publishing Group" /> <meta name="citation_publication_date" content="2024/08/02" /> <meta name="citation_mjid" content="bmj;386/aug02_4/q1672" /> <meta name="citation_id" content="386/aug02_4/q1672" /> <meta name="citation_public_url" content="https://www.bmj.com/content/386/bmj.q1672" /> <meta name="citation_abstract_html_url" content="https://www.bmj.com/content/386/bmj.q1672.abstract" /> <meta name="citation_full_html_url" content="https://www.bmj.com/content/386/bmj.q1672.full" /> <meta name="citation_pdf_url" content="https://www.bmj.com/content/bmj/386/bmj.q1672.full.pdf" /> <meta name="citation_issn" content="1756-1833" /> <meta name="citation_journal_abbrev" content="BMJ" /> <meta name="citation_doi" content="10.1136/bmj.q1672" /> <meta name="citation_pmid" content="39095071" /> <meta name="citation_volume" content="386" /> <meta name="citation_article_type" content="Other" /> <meta name="citation_section" content="Feature" /> <meta name="citation_author" content="Nuzhat Khan" /> <meta name="citation_author_institution" content="Delhi" /> <meta name="citation_author" content="Zoya Hussain" /> <meta name="citation_author_institution" content="Delhi" /> <meta name="citation_reference" content="citation_journal_title=Psychol Stud (Mysore);citation_author=P. Kesharvani;citation_author=K. Sarathy;citation_title=Living in a protracted conflict area: mental health burden of women in Manipur, India;citation_pages=445-54;citation_volume=65;citation_year=2020;citation_doi=10.1007/s12646-020-00581-9" /> <meta name="citation_reference" content="Zaman R. “One generation is going to lose out”: Manipur strife is taking a toll on children’s education. Scroll 2023 Aug 15. https://scroll.in/article/1054072/one-generation-is-going-to-lose-out-manipur-strife-is-taking-a-toll-on-childrens-education" /> <meta name="citation_reference" content="Manipur violence: “12 694 children in relief camps; 100 severely traumatized.” Imphal Free Press 2023 Sep 5. https://www.ifp.co.in/manipur/manipur-violence-12694-children-in-relief-camps-100-severely-traumatized" /> <meta name="citation_reference" content="citation_journal_title=Int J Environ Res Public Health;citation_author=B. Carpiniello;citation_title=The mental health costs of armed conflicts-a review of systematic reviews conducted on refugees, asylum-seekers and people living in war zones;citation_volume=20;citation_year=2023;citation_pmid=36833537;citation_doi=10.3390/ijerph20042840" /> <meta name="citation_reference" content="Loitongbam N. Post traumatic stress disorder (PTSD) and beyond. E-Pao. 19 Jul 2023. https://e-pao.net/epSubPageExtractor.asp?src=education.Health_Issue.Post_Traumatic_Stress_Disorder_PTSD_and_beyond_By_Nelson_Loitongbam" /> <meta name="citation_reference" content="One of eight people in Manipur suffering from mental health issue.” Imphal Free Press 2023 Oct 11. https://www.ifp.co.in/health/one-of-eight-people-in-manipur-suffering-from-mental-health-issue" /> <meta name="citation_reference" content="National Institute of Mental Health and Neuro Sciences Bengaluru. in collaboration with partner institutions. National mental health survey of India, 2015-16—summary. 2016. https://ruralindiaonline.org/en/library/resource/national-mental-health-survey-of-india-2015-16-summary/" /> <meta name="citation_reference" content="Mental health issues in Manipur higher than national average: Minister Sapam Ranjan. Imphal Free Press 2022 Nov 16. https://www.ifp.co.in/manipur/mental-health-issues-in-manipur-higher-than-national-average-minister-sapam-ranjan" /> <meta name="twitter:title" content="Manipur’s mental health crisis, a year after violence" /> <meta name="twitter:card" content="summary" /> <meta name="twitter:description" content="The ongoing turmoil in India’s north east is having repercussions beyond physical wounds. Nuzhat Khan and Zoya Hussain report on the trauma—and the dearth of mental health support plaguing Manipur On 3 May last year Esther Haokip, a 23 year old Kuki student, was inside her hostel when a violent mob attacked her university in Manipur, northeast India. She recalls that a mob of 40 men climbed the walls and entered the hostel premises, set vehicles on fire, and even pelted stones at windows before breaking down the main gate. Haokip, who currently lives with her relatives in Delhi, said that the girls in her hostel started hiding in groups in bathrooms as they heard the mob breaking the doors of their rooms. “Initially I thought that it hadn’t affected me,” she says. “But as time goes by it becomes more difficult to cope. I find myself having multiple breakdowns. I get scared when I hear people shouting.” It’s been one year since ethnic clashes erupted in the Indian state of Manipur—the start of a murderous civil war between the Meitei and Kuki communities that has engulfed the northeastern state, leaving at least 227 people dead and around 70 000 displaced. Thousands of people from both communities continue to languish in relief camps throughout the state: Manipur has at least 350 camps. The violence in the region has left women and children struggling to cope with psychological trauma, including depression, sleeplessness, panic attacks, and post-traumatic stress disorder (PTSD). The six decade long conflict in Manipur had already significantly affected the mental health of the region’s population, a 2020 study having estimated a 20% prevalence of mental health problems in adults before the most recent outbreak of violence.1 This figure is notably higher than the national average of 10.6%. The conflict’s …" /> <meta name="og-title" property="og:title" content="Manipur’s mental health crisis, a year after violence" /> <meta name="og-url" property="og:url" content="https://www.bmj.com/content/386/bmj.q1672" /> <meta name="og-site-name" property="og:site_name" content="The BMJ" /> <meta name="og-description" property="og:description" content="The ongoing turmoil in India’s north east is having repercussions beyond physical wounds. Nuzhat Khan and Zoya Hussain report on the trauma—and the dearth of mental health support plaguing Manipur On 3 May last year Esther Haokip, a 23 year old Kuki student, was inside her hostel when a violent mob attacked her university in Manipur, northeast India. She recalls that a mob of 40 men climbed the walls and entered the hostel premises, set vehicles on fire, and even pelted stones at windows before breaking down the main gate. Haokip, who currently lives with her relatives in Delhi, said that the girls in her hostel started hiding in groups in bathrooms as they heard the mob breaking the doors of their rooms. “Initially I thought that it hadn’t affected me,” she says. “But as time goes by it becomes more difficult to cope. I find myself having multiple breakdowns. I get scared when I hear people shouting.” It’s been one year since ethnic clashes erupted in the Indian state of Manipur—the start of a murderous civil war between the Meitei and Kuki communities that has engulfed the northeastern state, leaving at least 227 people dead and around 70 000 displaced. Thousands of people from both communities continue to languish in relief camps throughout the state: Manipur has at least 350 camps. The violence in the region has left women and children struggling to cope with psychological trauma, including depression, sleeplessness, panic attacks, and post-traumatic stress disorder (PTSD). The six decade long conflict in Manipur had already significantly affected the mental health of the region’s population, a 2020 study having estimated a 20% prevalence of mental health problems in adults before the most recent outbreak of violence.1 This figure is notably higher than the national average of 10.6%. The conflict’s …" /> <meta name="og-type" property="og:type" content="article" /> <meta name="og:image" property="og:image" content="https://www.bmj.com/sites/default/files/highwire/bmj/387/8450.cover-source.jpg"/> <meta name="twitter:card" content="summary_large_image"><meta name="twitter:image" property="twitter:image" content="https://www.bmj.com/sites/default/files/sites/defautl/files/attachments/bmj-article/2024/08/manipur_violence_protest_india.png"><meta name="twitter:title" content="Manipur’s mental health crisis, a year after violence" /><link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/386/bmj.q1672.full.txt" /> <script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Manipur\u2019s mental health crisis, a year after violence","hwUrl":"https://www.bmj.com/content/386/bmj.q1672","hwPath":"/content/386/bmj.q1672","hwType":"journal 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& Views</a></li> <li>Manipur’s mental...</li> <li class="active last">Manipur’s mental health crisis, a year after violence</li> </ol> <a id="main-content"></a> <div class="region region-content"> <section id="block-system-main" class="block block-system clearfix"> <div class="panel-display" > <div class="hero"> <div class="hero-wrapper"> <div class="hero-content" style="position: relative; left: 0px; top: 35.5px;"> </div>  </div>  </div>  <div class="row"> <div class="left-content col-xs-12 col-sm-8 col-md-8 col-lg-8"> <article> <div class="panel-pane pane-highwire-article-citation" > <div class="pane-content"> <div class="highwire-article-citation highwire-citation-type-highwire-article node1099434" data-node-nid="1099434" id="node-1099434--22074205707" data-pisa="bmj;386/aug02_4/q1672" data-pisa-master="bmj;bmj.q1672" data-apath="/bmj/386/bmj.q1672.atom"><cite class='highwire-cite highwire-citation-bmj-article-top'> <span class='highwire-cite-article-type'>Feature</span> <span class='bmj-series-title'>Mental Health</span> <h1 class="highwire-cite-title" id="page-title">Manipur’s mental health crisis, a year after violence</h1> <span class='highwire-cite-journal'>BMJ</span> <span class='highwire-cite-published-year'>2024</span>; <span class='highwire-cite-volume-issue'>386</span> <span class='highwire-cite-doi'> doi: <a href="https://doi.org/10.1136/bmj.q1672">https://doi.org/10.1136/bmj.q1672</a></span> <span class='highwire-cite-date'>(Published 02 August 2024)</span> <span class='highwire-cite-article-as'> Cite this as: <span class="italic">BMJ</span> 2024;386:q1672 </span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs pane-panels-ajax-tab-tabs" > <div class="pane-content"> <ul class="tabs inline panels-ajax-tab"><li class="first"><a title="Article Tab - Article" href="/content/386/bmj.q1672" class="panels-ajax-tab-tab" data-panel-name="jnl_bmj_tab_art" data-target-id="highwire_article_tabs" 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class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://www.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_bmj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article extract-view"><span class="highwire-journal-article-marker-start"></span><div class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">Nuzhat Khan</span>, </li><li class="last" id="contrib-2"><span class="name">Zoya Hussain</span><span class="contrib-role">, freelance journalists</span></li></ol><ol class="affiliation-list"><li class="aff"><address>Delhi</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="em-link"><span class="em-addr">zoya.h97{at}gmail.com</span></span></li></ol></div><div class="teaser"><p id="p-1">The ongoing turmoil in India’s north east is having repercussions beyond physical wounds. <strong>Nuzhat Khan</strong> and <strong>Zoya Hussain</strong> report on the trauma—and the dearth of mental health support plaguing Manipur</p></div><p id="p-2">On 3 May last year Esther Haokip, a 23 year old Kuki student, was inside her hostel when a violent mob attacked her university in Manipur, northeast India. She recalls that a mob of 40 men climbed the walls and entered the hostel premises, set vehicles on fire, and even pelted stones at windows before breaking down the main gate. Haokip, who currently lives with her relatives in Delhi, said that the girls in her hostel started hiding in groups in bathrooms as they heard the mob breaking the doors of their rooms.</p><p id="p-3">“Initially I thought that it hadn’t affected me,” she says. “But as time goes by it becomes more difficult to cope. I find myself having multiple breakdowns. I get scared when I hear people shouting.”</p><p id="p-4">It’s been one year since ethnic clashes erupted in the Indian state of Manipur—the start of a murderous civil war between the Meitei and Kuki communities that has engulfed the northeastern state, leaving at least 227 people dead and around 70 000 displaced. Thousands of people from both communities continue to languish in relief camps throughout the state: Manipur has at least 350 camps.</p><p id="p-5">The violence in the region has left women and children struggling to cope with psychological trauma, including depression, sleeplessness, panic attacks, and post-traumatic stress disorder (PTSD). The six decade long conflict in Manipur had already significantly affected the mental health of the region’s population, a 2020 study having estimated a 20% prevalence of mental health problems in adults before the most recent outbreak of violence.<span class="xref-bibr">1</span> This figure is notably higher than the national average of 10.6%.</p><div class="section other1" id="sec-1"><h2 class="">Displaced</h2><p id="p-6">The conflict’s … </p></div><span class="highwire-journal-article-marker-end"></span></div><span id="related-urls"></span></div><a href="https://www.bmj.com/content/386/bmj.q1672.full" class="hw-link hw-link-article-full-text">View Full Text</a></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-bmj-article-purchase-subscribe" > <div class="pane-content"> <div class="panel-display row bootstrap-twocol-6-6" id="mini-panel-bmj_article_purchase_subscribe"> <div class="panel-panel col-left col-xs-6 col-sm-6 col-md-6 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data-pisa="bmj;386/aug02_4/q1672" data-pisa-master="bmj;bmj.q1672" data-apath="/bmj/386/bmj.q1672.atom"><div id="jnl_bmj_custom_authors" style="display: none;"><span data-delta="0"><span class="nlm-given-names">Nuzhat</span> <span class="nlm-surname">Khan</span></span>, <span data-delta="1"><span class="nlm-given-names">Zoya</span> <span class="nlm-surname">Hussain</span> <span class="nlm-role">freelance journalists</span></span></div> <div class="highwire-cite highwire-cite-highwire-article highwire-citation-bmj-article-citation-export clearfix" > <span class="highwire-cite-authors" ><!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" "http://www.w3.org/TR/REC-html40/loose.dtd"> <html><body><span data-delta="0"><span class="nlm-surname">Khan</span> <span class="nlm-given-names">N</span></span>, <span data-delta="1"><span class="nlm-surname">Hussain</span> <span class="nlm-given-names">Z</span></span>. </body></html> </span> <span class="highwire-cite-title 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