Mental Health

Mental Health: Trends

Prevalence of Mental Disorders in Nepal

Data from 2020: 10% of Nepalese adults are esti­mat­ed to have expe­ri­enced a men­tal dis­or­der in their life­time; 4.3% cur­rent­ly expe­ri­enc­ing men­tal dis­or­der.
The num­ber of peo­ple who have expe­ri­enced a men­tal dis­or­der is expect­ed to increase, espe­cial­ly in light of Covid-19, pover­ty, unem­ploy­ment and polit­i­cal insta­bil­i­ty.

Source: Nepal Health Research Council. (2020). Report of National Mental Health Survey, Nepal 2020. https://nhrc.gov.np/wp-content/uploads/2022/10/National-Mental-Health-Survey-Report2020.pdf

Mental Health: Causes

Covid-19 Situation, Worsening Mental Health Situation

Poor psy­cho­log­i­cal health dur­ing Covid-19: a study found that half of respon­dents suf­fered from at least one psy­cho­log­i­cal symp­tom.
The num­ber of sui­cides increased dur­ing Covid-19: 16–18 sui­cides a day dur­ing Covid-19.

Suicides

An alarm­ing trend of increased sui­cides: 7223 sui­cides in 2023/24 (high­est ever record­ed), 72% increase in the past decade.
This is an increas­ing trend since the pre­vi­ous peak that occurred dur­ing Covid-19 (2020/21).

Timeline of Events

∙ March — July 2020: First nation­wide lock­down ini­ti­at­ed, pro­hi­bi­tion of domes­tic and inter­na­tion­al trav­el, clo­sure of all non-essen­tial ser­vices.
∙ April — Sep­tem­ber 2021: Sec­ond waver of Covid hit Nepal, renew­ing restric­tions and lock­down, restrict­ing pub­lic gath­er­ings and increas­ing iso­la­tion amongst Nepalese.

Impacts of Covid-19 on Mental Health

Pro­longed peri­ods of iso­la­tions had sig­nif­i­cant­ly impact­ed the men­tal health of the Nepalese:
∙ Cur­fews and lock­downs sig­nif­i­cant­ly increased instances of social iso­la­tion and weak­ened social sup­port sys­tems, con­tribut­ing to increased feel­ings of anx­i­ety and depres­sion.
∙ Covid-19 sig­nif­i­cant­ly affect­ed low-income com­mu­ni­ties, result­ing in job­less­ness and loss of incomes, dis­pro­por­tion­ate­ly affect­ing house­holds which rely on small shops for income.

Mental Health: Issues Faced

Stigma and Cultural Barriers

∙ Soci­etal view that ill­ness of the body and that of the mind are sep­a­rate
◦ Affects treat­ment-seek­ing behav­iour, lack of open dia­logue
∙ Lack of under­stand­ing about the impacts of men­tal health
◦ Men­tal heath issues per­ceived to be caused by “spir­its” and “black mag­ic”
∙ Men­tal ill­ness often per­ceived as a “spir­i­tu­al dys­func­tion” or a “weak mind” that needs to be con­trolled by behav­iour change rather than seek­ing men­tal health care
◦ Resort­ing to faith heal­ers and tra­di­tion­al heal­ing sys­tems

Limited Access to Services

∙ Human Resources Avail­able
◦ Est. 144 psy­chi­a­trists and 3 child psy­chi­a­trists in Nepal (0.5 per 100,000), 35 clin­i­cal psy­chol­o­gists
∙ Facil­i­ties
◦ 1 spe­cial­ist pub­lic-sec­tor psy­chi­a­try hos­pi­tal and 4 pri­vate-sec­tor psy­chi­a­try hos­pi­tals
∙ Urban-rur­al Divide
◦ Major­i­ty of spe­cial­ist care in major urban areas
∙ Train­ing
◦ 15–20 psy­chi­a­trists, 2–3 clin­i­cal psy­chol­o­gists added year­ly
◦ No train­ing pro­grams for sub-spe­cial­ties

Policy

∙ No stand­alone Men­tal Health Act
∙ The Act Relat­ing to Rights of Per­sons with Dis­abil­i­ties, 2074 (2017)
◦ Pro­vides cit­i­zen’s rights to health, reha­bil­i­ta­tion, social secu­ri­ty and recre­ation
◦ Sec­tion 35 & 36: Ensures addi­tion­al ser­vice facil­i­ties for peo­ple with men­tal or psy­choso­cial dis­abil­i­ties
∙ The Nation­al Men­tal Health Strat­e­gy and Action Plan 2020
◦ Pro­tec­tion of basic human rights for peo­ple with men­tal health prob­lems and psy­choso­cial dis­abil­i­ties