The case of a 13 year old teenager, who was abducted on March 15 and then raped for nine days before fleeing her captors, is getting more sad and desperate with each passing day.

Having been subjected to continuous sexual assault for nine days by eight men while abducted makes for an immense trauma that she had been struggling with for more than a month.

Police apathy and stubbornness compounded the problem as they refused to add the charge of rape to the initial FIR. This led to the victim feeling let down, and not being believed. While the family was supportive and an NGO later stepped in; the media, the intellectual fraternity and the political noise makers did not lend her any support. Placed in such a helpless, lonely and frustrating situation, coping with the devils in her mind became even worse and she attempted to cut her wrist. Two days later she took an overdose of medicines.

Psychiatrists recognize such actions as a cry for help by a victim who is not being believed, supported and is looking at death as the only outcome from her trauma. However, faced with a system that does not look at rape victims especially teenagers as having any mental health needs, she was admitted to a local hospital. ‘Counseling’, was started but no mental health assessment was done and her needs and requirement of Psychiatric care were still not addressed.

The total lack of care and empathy for her was further apparent when she was placed in a general ward at AIIMS, her identity and the nature of her trauma clear and open for all to look at and talk about. All this while, the girl herself is possibly going deeper into depression, resulting in her third attempt at ending her life when she took another overdose, recorded a message for her mother, and locked herself in the hospital bathroom. Suicidal intent cannot be clearer than this. Yet, an AIIMS official claims that she could not have attempted suicide as she was in the general ward!! Clearly, this official (!) has no experience of caring for people with emotional disturbances leading to suicidal thoughts or he would/should have known that a separate room with a one to one nursing team is the only tested method of preventing suicide.

Thankfully, the papers report that she is now under psychiatric care and access is closely restricted. Hopefully medicines have been started and she is now getting supportive psychotherapy by trained mental health professionals and NOT ‘counseling’ by a social worker.

Society especially government functionaries need to learn from this sad story.

Rape is not merely a physical trauma.
Rape is not bad only if there is brutality involved. Rape is itself brutal.
Rape is a mental trauma. It is about feeling helpless while being threatened and abused.

Physical wounds may be controlled with antibiotics, analgesics and anti-inflammatory medicines BUT what about the scars in the mind. Rape is one of the commonest triggers for Post Traumatic Stress Disorder (PTSD). Nightmares, flashbacks, terror attacks and feelings of insecurity can persist for a very long time. Add to this inner turmoil, the judgmental stance of Indian society, the disbelief of our police and the insensitiveness of our health care practitioners; it’s a recipe for extremely worse outcomes.

Mental health assessment and supportive psychotherapy should be offered to ALL rape victims. This should be a priority second only to life threatening injuries. Listening, supporting, believing, empathising, and being non judgmental are essential elements of therapy. Sleep difficulties, depressed mood, crying spells and anger are all indicators of poor mental health. Medicines must be offered to ensure adequate sleep, along with appropriate medicines for anger, mood and hopelessness. A proper mental health risk assessment would preempt impulsive self harm and/or overdose. Risks of over-treating are less than the risks of not treating as is very clearly apparent in this girl’s experience.

Social workers and social welfare officials (who were apparently caring and supporting the teenager and her family) have apparently failed to recognize poor mental health and risks of suicide in this instance. Do they have the training and skills to do a mental health assessment? If not, then training should be urgently provided. The Delhi Council for the Protection of Child Rights (DCPCR) should take suo-moto cognizance of this issue and prod the Delhi Govt to make fast changes.

Alternatively, working closely with mental health professionals should be actively encouraged and practiced. Rape victims are not merely dealing with a social issue, but a psychosocial disorder that can be addressed by Psychiatrists and Social workers working together-not excluding one or the other.

Hopefully, things will change and the next time the response of the police, the media, the social welfare ministry and the government will be better!