What is the situation of mental health in Nepal?

In Nepal, less than 10% of people with mental health problems are receiving professional support. Nepal’s female suicide rate is the 3rd highest in the world. A 2020 survey* revealed that, 10% of people in Nepal will experience a mental health disorder and 7.2% experience suicidality at some point in their life.

False beliefs and practices surrounding mental health in Nepal especially rural areas sometimes include those suffering being locked in a cage; mental illness being blamed on a person’s misdeeds and sins in their present life or a past life. Due to the stigma and discrimination associated with it, people often do not talk about mental health, nor do they seek help.

What is the situation of mental health in Bajhang, Far West Nepal?

Bajhang is a hilly and rural district of Nepal bordering Tibet to the north. It is the second least developed district among the nine in the Far West. Mental health is still stigmatised in most areas and not all the health workers understand about the identification and treatment options of mental health. People often believe that mental health disorders cannot be treated, or rely on superstitious practices. Family members may isolate clients within their homes with separate eating and sleeping arrangements, occasionally chaining up those with severe conditions. Patients with mental health problems were often referred outside the district for treatment. Before UMN intervention, health volunteers had no knowledge about mental health and sometimes believed those suffering were cursed.

How is UMN helping the situation?

UMN is working with communities to educate people and help those who need support to address mental health conditions. We do identification and referral of mental health problems, community sensitisation and stigma-reduction activities. We help build the capacity of local health facility staff in mental and psycho-social health and help to integrate mental health care services into existing health care systems. We also train many different groups and workers to recognise mental health needs in their community and know how to respond.
Specific activities:

• Mental health camps – UMN’s mental health project organised the first ever mental health camp in Bajhang in February 2023 and a second in October 2023. Over 100 people suffering from different forms of mental disorders were identified and they received essential care, counselling, and medication. This shows the significant need for mental health support in the area.
• For health workers – A 6-day government training package then 3 days of supervision was provided through UMN to 13 health workers by psychiatrists and psychologists.
• For health volunteers – Training on identifying mental health disorders and referral mechanisms was provided to 14 Female Community Health Volunteers, and orientation on mental health causes and treatments to 13 mothers’ groups.
• Home visits – People with mental health problems received individual sessions where they were followed up on medications and provided with basis psychosocial support. Their family members were given information about the problem and the importance of regular medication.

What are the estimated costs to support those suffering from mental health problems?

• USD 4 – cost of one counselling session from a local counsellor
• USD 11 – medicine costs for a month per person
• USD 90 – cost of having a psychiatrist visit an area / hospital per day (excluding travel).

* National Mental Health Survey of Nepal, 2020  https://nhrc.gov.np/wp-content/uploads/2022/10/National-Mental-Health-Survey-Report2020.pdf