Nepal is a country in South Asia with a rich and diverse culture. Most Nepalese people have a perception of the self in which the mind and body are considered to be separate. As a result, they typically attribute mental illness to spiritual dysfunction. People who have mental health problems are also targets of stigma and discrimination. According to the World Health Organization (WHO), more than 1 million people are estimated to currently have mental health disorders in Nepal.
Mental health is a matter of paramount importance. Poor mental health can lead to serious physical and social problems, which impact a person’s quality of life. Mental health issues are often linked to poverty because they lead to problems with maintaining employment and important social relationships. It is common for people who suffer from untreated mental illness to live financially unstable and precarious lives. According to the 2019 UNICEF multiple indicator cluster surveys (MICS) in Nepal, more than 17% of Nepalese people were considered multidimensionally poor. In Nepal, there is a lack of resources and support for people with mental health issues, especially those who experience the struggles of living in poverty.
Nepalese Culture and Mental Health
Nepal spends 7.5% of its GDP on health care, which is far below the global average of 10% of a nation’s GDP. It is common for Nepalese people to visit traditional healers in order to address mental health. However, people in Nepal have limited availability and access to traditional healers, especially in rural areas. Traditional healers that Nepalese people typically rely upon do not have the formal training required to properly identify and treat mental illnesses.
As of 2022, there are 0.36 psychiatrists working in the mental health sector per 100,000 people in Nepal, with a majority of professionals concentrated in urban areas. Low economic prioritization of mental health issues within the country contributes to a lack of public awareness regarding mental health. Furthermore, cultural stigmas have contributed to fears of discrimination and rejection from friends, family and community members. As a result, people become hesitant to seek mental health treatments in Nepal.
A Growing Need
From 1996 till 2006, the people of Nepal endured a violent civil war that killed more than 13,000 people and displaced thousands. The country is still recovering from the violent conflict, which has likely contributed to a growing prevalence of PTSD, depression and anxiety disorders among the Nepalese population. Nepal’s deadly environmental disasters have also affected them. An earthquake in April 2015 killed more than 8,000 people and injured more than 20,000 people.
People that events of this nature affect typically require significant psychological first aid in order to alleviate trauma and other long-term mental health problems associated with emergencies. Survivors of these events usually rely upon international humanitarian NGOs for mental health care and services in large numbers. Nepal’s weak integration of mental health services into primary health care led many Nepalese people to become dependent upon NGOs and international organizations for help in the wake of their suffering and loss.
Advocating for Mental Health
Advocates for mental health in Nepal point to policy change, rehabilitation efforts, and more healthcare infrastructure as solutions for the problems Nepalese people are facing. Nepalese organizations such as KOSHISH are working to promote mental health awareness and psychosocial well-being throughout the country. Established in 2008, the organization is a nonprofit that operates as a national mental health self-help organization and advocacy group. KOSHISH advocates for mental health issues on the national policy level. It aims to promote mental health awareness as well as reduce the stigma and discrimination surrounding these issues. The organization provides psychosocial support programs, treatment, and residential care for women who are victims of gender-based abuse.
The momentum behind mental health advocacy is growing globally and spreading to countries like Nepal. In the past, the law in Nepal equated mental illness to madness and provided no legitimate legislation related to the treatment of mentally ill people. Over the past years, Nepal has significantly increased its political commitment to mental health and psychosocial issues. In 2019, the country expanded its national health policy to include a strategy that incorporates mental health services into its healthcare systems. Nepal now considers mental healthcare a basic health service. The growing progress of mental health literacy and awareness within the country will likely lead to more widespread mental health awareness and support for the people who need it.
– Dylan Priday