FACE-TO-FACE
Mental hygiene is equally important as personal hygiene. It's high time the government invested in mental health insofar as to meet the needs of individuals battling mental illness. In this context, Sanjog Karki of The Himalayan Times had a tête-à-tête with Anjan Kumar Dhakal, an experienced clinical psychologist and mental health practitioner who has been providing mental health services at Kathmandu-based Kanti Children's Hospital, as the latter shared his insights on the matters related to mental health. Excerpts:
Q. Just as CT scan is done to monitor and plan treatment for injuries, tumors, and the like, is there the availability of psychological tools to assess the psychological state of mental health patients?
A. We use various types of psychological tools to access the psychological state of patients. The behavioral attributes of patients are analysed on the basis of various testing tools so as to arrive at a diagnosis and support treatment plans.
Q. Can the belief system of patients have a significant impact on the psychotherapy and counselling sessions? In case your patients strongly believe in shamans, do you encourage the former to seek services provided by the latter?
A. Of course, the belief system of patients can have a significant impact on the therapeutic sessions. If they are satisfied with the outcomes of the treatment services provided by shamans, then we do not prevent them from doing so. We do not keep patients from availing the services provided by shamans as long as both the parties are doing well in their lives. After all, it's an age-old belief of individuals to seek the help of shamans.
Q. How affordable is psychotherapy and counselling in the context of Nepal?
A. The cost of psychotherapy varies. For instance, Gestalt therapy is quite expensive. Nepal Health Professional Council is an autonomous body established to register all the health professionals, including mental health practitioners, other than medical doctors and nurses. The psychotherapy and counselling fee is determined accordingly.
Q. How many seats are allocated for MPhil in the Clinical Psychology programme?
A. Currently, six seats - four at Kathmandu-based Tribhuvan University Teaching Hospital and two at Birgunj-based National Medical College - are allocated for MPhil in the Clinical Psychology programme.
Q. Are there some mental disorders that can be used for one's own advantage? For instance, an individual dealing with the manic episodes of bipolar disorder may miraculously achieve remarkable feats in a particular task or field. What is your take on this matter?
A. First of all, the term 'disorder' itself suggests an abnormal state of mind. So, in my view, an unhealthy state of mind can never yield viable outcomes for oneself or others. Even though a particular mental illness seems to be faring well in fulfilling one's purpose for a short while, it is detrimental to one's mental well-being in the long run. Acting like a hypochondriac or being a victim of factitious disorder are a few examples of such illness. Individuals with schizophrenia or in a state of paranoia involving manic episodes fall under this category.
Q. What is the adherence rate of patients who reach out to you for mental health support?
A. As far as my patients are concerned, there is an adherence rate of 70-75 per cent. Those patients who reach out to me for mental health support are satisfied by the services they have received so far.
Q. What sort of efforts ought to be made at the policy making level to address the needs of patients with mental health conditions?
A. It is necessary to include mental health in the school level curriculum. Moreover, it's crucial for the government to allocate an adequate budget in the sector of mental health if we are to alleviate the ordeals of patients scourged by mental illness. The onus lies on the government to make smart investments in mental health.
