The shortage of mental health workers in Nepal is a major challenge in improving mental health care in the country. This problem is even more severe in the rural areas
MAY 16
Do you care about your mental health as well as your physical health? If not, why do you ignore your mental health? Do people stigmatise mental health in our society? If yes, why are mental health issues still stigmatised?
Mental health stigma refers to the negative attitudes, beliefs and stereotypes that people hold about mental illness and those who experience mental health problems.
Nepal, like many countries around the world, is experiencing a growing mental health crisis. The societal changes, technological advancements, ongoing COVID-19 pandemic, economic challenges and other stressors have contributed to the increase in the rate of anxiety, depression, suicide, substance abuse disorders and other mental health issues.
Poverty, conflict, displacement, unemployment and labour migration are other factors that put the Nepali population at risk of poor mental health.
According to the World Health Organization (WHO), approximately 1 in 4 people globally experience mental health prob-lem at some point in their lives. A global shortage of mental health workers has also been of growing concern, with an estimated 970,000 mental health professionals needed to meet the current demands.
Mental health is often ignored.
It is given less priority than physical health due to a variety of factors, including cultural attitudes and beliefs regarding mental illness, discrimination of mentally ill persons and the like.
Additionally, lack of understanding about the impact of mental health on overall well-being and limited resources for mental health care are also responsible for the ignorance about the disease.
In Nepal, most of the people think that suffering from mental illness is as fatal as madness. A person suffering from mental ailment is deemed unfit to live in society. Families don't know how to tackle such issues. The problem gets complicated when people in the society think mental health issues are caused by the spirits or black magic.
Individuals with severe mental disorders and their family members thus become the targets of stigma.They are prone to discrimination.
At this point, they hesitate to approach health professionals for appropriate treatment. Even the patients with neurotic disorders do not like to consult mental health professionals for they are subjected to stigmatisation. This situation makes it difficult for individuals to consult mental health specialists.
Stigmatisation is a severesocial problem. It may cause suicide. Social discrimination leads hopelessness and helplessness.
In many cases, it increases suicidal thoughts and behaviours.
The suicide rate in Nepal is still a serious issue. According to the World Health Organisation, the suicide rate in Nepal was 20.8 per 100,000 people in 2016, which is higher than the global average of 10.5 per 100,000 people.
The stigma related to mental health in Nepalmay extend even to the mental health workers.
Mental health professionals, such as psychiatrists, psychologists and counselors, may also be subjected to negative attitudes and stereotypes. This condition may impact negatively in their efficiency.
The shortage of mental health workers in Nepal is a major challenge in improving mental health care inthe country. This problem is even more severe in the rural and remote areas. According to WHO, in Nepal (2021), there were only 0.17 psychiatrists, 0.03 psychologists and 0.21 nurses per 100,000 people. WHO recommends a minimum of 1 mental health worker per 10,000 population.
Mental health care is often underfunded and understaffed, particularly in low- and-middle-income countries. This situation leads delay in mental health services, ineffectivetreatments and many practical barriers in the service areas.
Furthermore, a significant lack of education and awareness is the next big problem in mental health service delivery. Due to lack of it, mental health service is yet to foster in Nepal.
The availability of mental health professionals, unaffordable treatment and transportation challenges have made delivery of mental health services difficult in Nepal.
To address the mental health challenges, a sound curriculum-based education relevant to mental health can certainly play a great role. Raising mental health awareness is important as well. Non-government organisations (NGOs) have intervened to create awareness, but their presence is limited to a few locations of the country.
Mental health issue is not as terrible as the common people generally think in society. Education cum awareness campaigns and outreach efforts can definitely help educate the public people about mental health. This process facilitates people to take mental health issues normally and encourage them to take an easy approach to mental health services.
Genuine efforts are needed to improving resourceful mental health services both in rural and urban areas.
This involves, among others, training and recruitment of mental health professionals.
Likewise, the establishment of mental health clinics, the expansion of teletherapy, telehealth service, online mental health resources and support services in underserved areas will help improve basic mental health services.
It is apparent that the condition of mental health service in Nepal is rather poor. Although a mental health policy has existed in Nepal since 1997, its implementation leaves much to be desired. Mental health services are concentrated in the big cities and budget allocated for mental health is minimal, with the health sector receiving just about 3 per cent of the government budget. Both the people and the government should thus show concern for improving mental health service through the development of an appropriate plan of action.
Tamang is mental health counselor at Dhairya Cancer Foundation
A version of this article appears in the print on May 17, 2023, of The Himalayan Times.