Nepal

Nepal

1. Background of Nepal
2. The background of the mental health care in Nepal
3. Studies and numbers

1. Background of Nepal
For many travellers, Nepal is paradise on earth. Wedged between the Hymalayan mountains and the jungle of India, this is a land of yaks and yetis, monasteries and mantras, snow peaks and Sherpas, temples and tigers, magic and mystery. (Lonely planet)

This is surely true, it is a beautiful country with very friendly people and a wonderful diversity in population and religions.
And … at the same time  it is the poorest country of Asia, almost squeezed between the two big neighbours, India and China which influences and increases the political instability.
More over a decade civil war, which ended in 2008, and the earthquakes in 2015 are leaving Nepal with many traumatised people, and in an ecological disaster.

2. The background of the mental healthcare
Although there are not always clear reliable figures on health and socio-economic indicators at hand, there is a gradual improvement over the years.However the figures for illiteracy and infant mortality are still one of the highest in the world. Less than 3% of the national budget is allocated to the health sector and only 1% of the health care budget is spend on mental health care. And because mental health care and awareness on mental health care is not developed, stigmatisation is still very strong. The service, comprising  just  a little  bit more than 50 psychiatrists along with a few psychiatric nurses and clinical psychologists (mainly practicing in modern health care facilities) has started showing its impact—however this is limited to specific urban areas and does barely reach the remote areas of the country.

However, we see a change: more and more young psycho-social counsellors are trained and send out to the remote areas and provide community work, health education and individual counselling.

3. Studies and numbers
Different studies conducted in Nepal indicate the high prevalence of mental illness in Nepal. A recent estimate suggested that 6 million people are suffering from mental illness. A survey conducted in a small village of Nepal indicated that 18.4 % of the population had diagnosable mental illness and a survey carried out among hospitalized patients, reports that more than half of them deal with Post Traumatic Stress Disorder symptoms, and about 80% of them with other anxiety or depressive disorders.

A survey conducted in the Terai region (two districts; N=896) showed that of the total population 25-30% are suffering from some form of mental illness. In 2007/2008, CVICT in collaboration with TPO-Nepal conducted a study in three districts, it was found that 27.5% of the people were suffering from depression, 22.9 % from anxiety disorders and 9.6%  of Post Traumatic Stress Disorder.
A report of Child Workers in Nepal Concerned Centre (2002) reports that 95% of all street children are somehow addicted to drugs!

After the earthquakes in 2015, psychologists report that there is an enormous increase of depression, alcohol addiction, suicide and because of the lack on mental healthcare, many young people show characteristics of hysterical conversion.