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There is a growing concern for people’s mental well-being as reports indicate an alarming rise in suicide rates in Nepal. According to data published by the Epidemiology and Disease Control Division (EDCD), suicide rates have surged by a staggering 72% over the past decade. Among various contributing factors, mental health issues stand out as the predominant cause of the alarming rise in suicides, emerging as a pressing concern not only in Nepal but also throughout the world. The impact of mental health problems is enormous in Nepal, mainly due to a lack of awareness and infrastructure to tackle them.

A significant challenge surrounding mental health illness in Nepal is the stigma and cultural barriers that come along with it. Mental illness is often misunderstood, as the lack of open dialogue about mental health hinders awareness, with sufferers facing discrimination and social exclusion. This prevents the sufferers from seeking timely help. Therefore, it is necessary to create awareness, foster understanding and promote empathy towards dismantling the cultural barriers.

Mental health services

Adding to the misery, access to mental health services in Nepal is limited, with shortages of mental health professionals, psychologists and counsellors, particularly in rural areas. According to a 2021 report published by World Health Organization (WHO), there were only 0.17 psychiatrists, 0.03 psychologists and 0.21 mental health specialised nurses per 100,000 people in Nepal. This is well below the WHO recommendation—at least one mental health worker per 10,000 population. Additionally, the concentration of mental health services in urban locations poses a service barrier for the population in remote regions. Increased investment in mental health infrastructures, training of professionals and establishment of community-based services can help address this critical issue.

Nepal’s socio-economic challenges, including poverty, political instability, unemployment and natural disasters, have also contributed to mental health burdens. These stressors are bound to increase anxiety, depression and other mental health disorders. Addressing the root causes of socio-economic challenges through poverty reduction initiatives, job creation, disaster management, political stability and good governance positively impact the mental health of people.

PTSD and youth support

Nepal experienced significant trauma from the devastating earthquake in 2015 and a decade-long gory civil war. A representative survey conducted four months after the earthquake identified one out of three adults with symptoms of depression and distressing levels of anger, one out of five engaged in hazardous drinking, and one out of ten having suicidal thoughts. Likewise, the decade-long armed conflict had an enormous impact on the psychological health of the people. This sheds light on how the distressing events of the recent past left lasting psychological scars on individuals and communities–a post-traumatic stress disorder (PTSD) condition requiring specialised care and support. Providing trauma-informed services, promoting resilience and incorporating mental health support into disaster response efforts are crucial steps towards healing and recovery. Unfortunately, the timely remedy for PTSD was not implemented during these and other similar traumatic events, contributing to the mental health burdens of the affected people.

Nepal has a considerable youth population, and addressing their mental health needs is paramount. Academic pressure, unemployment, substance abuse and a rapidly changing society contribute to their mental health challenges. Each year, following the announcement of academic results, particularly the Secondary Education Examination (SEE) and intermediate levels, a distressing number of students, unable to pass these examinations, tragically decide to take their own lives prematurely. For decades, this trend has been going on that can be resolved by implementing school-based comprehensive mental health programs, promoting emotional well-being and creating safe spaces for young people to seek support. Such approaches will impart a substantial difference in their mental health outcomes. Nepal can hope to ensure a brighter and healthier mental stress-free future for its youth by fostering awareness, providing accessible mental health care, and addressing the root causes of this crisis.

At present, there is a growing availability of internet-based interventions designed to support self-management and provide recovery-oriented information to individuals dealing with mental health challenges. While acknowledging that these tools may not be universally effective, they showed promise in efficiently addressing mental health concerns, especially among the young urban population. This approach could be a valuable addition to the efforts to mitigate mental health disorders in Nepal. Therefore, the relevant authorities must carefully consider the implementation of internet-based interventions for mental health disorders. It will be a significant step toward improving the mental well-being of the people, particularly in urban areas.

International collaborations

Collaboration between the government, non-governmental organisations (NGOs) and international partners is essential to develop a comprehensive mental health strategy to address the unique challenges faced by Nepal. Nepal can take a leaf from Germany’s approach to tackling mental health issues. Germany has a well-developed healthcare system that includes mental health services where people can access a range of services, including therapy, counselling and psychiatric treatment through public health insurance. Being an employee of a reputed German University and working in interdisciplinary research, experience tells me that German mental health experts are keen to support and collaborate with Nepali counterparts. Hence, Nepali psychiatrists and mental health workers should initiate to establish prospective collaborations.

To sum up, the increasing psychiatric problems in Nepal are a growing concern that cannot be ignored. Nepal can create a society that supports and empowers individuals with mental health conditions, fostering resilience and overall well-being. Mental health disorders drastically deteriorate the quality of life of many people of all backgrounds. The government and concerned health authorities must prioritise mental health by investing in awareness campaigns, destigmatising mental illness, and expanding access to mental health services to all segments of the population, especially those in remote areas. The government seems to have taken some steps to prioritise mental health by including mental health services in its National Health Policy, but the efforts are insufficient. It’s high time to design a state-of-the-art, contemporary and internationally endorsed strategy to alleviate the burdens of mental health disorders.

Source: The Kathmandu Post

Author: Pushpa Raj Joshi                          Senior scientist and neurobiologist at Martin-Luther University Halle-Wittenberg, Germany

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Mr. Ksheteez Rajbhandari
Mental Health Researcher
[email protected]