The annual World Mental Health Day (October 10) went almost unnoticed in Nepal this year, easily eclipsed by the Dashain celebrations. Yet there is no denying the scale of the problem in the country. There are no reliable data on the number of Nepalis suffering from mental health problems, the estimated figure ranging between 10 to 25 percent of the total population. Ten years of civil war, prolonged political instability, absence of job opportunities, rapid and unplanned urbanization, breakdown of traditional family structure, all contribute to a feeling of alienation and victimhood, which in time can manifest in mental health problems. Lack of trained manpower in the field (there are 30 psychiatrists to cater to a population of 30 million) compounds the problem. Even this limited manpower is concentrated in urban centers, chiefly Kathmandu. [break]
At least in the urban settings, the sigma surrounding mental health is gradually decreasing. It might be unrealistic to hope that the sigma goes away completely. Even in the developed world, the majority of those who suffer from mental ailments prefer to hide their problems. The people who are once tagged ‘mentally ill’ have a tough time competing for jobs against equally qualified candidates; internet makes it easy for potential employers to troll the medical records of applicants and those with mental health problems are easily cast aside. So although more awareness of mental illness is important, that is not enough. Forget stigma for a while. The problem right now is that even those looking for help don’t know where to get it. The government has recently launched a suicide helpline (around 11 people commit suicide in Nepal everyday). We don’t know how effective it has been, but more such initiatives are needed. It makes economic sense too. Although there have been no comparable studies in Nepal, a famous study in the US estimated that yearly cost of mental disorders for the country was as much as 2.5 percent of national GDP, according to World Health Organization, mostly due to “…lost employment and reduced productivity, impact on families and caregivers, levels of crime and public safety, and the negative impact of premature mortality.”
We don’t seem to have realized the gravity of the matter as yet. Clearly, national spending on mental health has to go up. For one of the country’s leading causes of disability and mortality, the government spends under a percentage of national health budget. Meanwhile, anxiety-related mental health diseases are mounting among the youngsters, so is the rate of depression. The level of postpartum depression is alarming too. We can no longer afford to ignore this pressing issue. In addition, emerging problems like the deteriorating mental health of old people, many of whom have either been abandoned by their children or are forced to live alone as their siblings have migrated abroad, present unique challenges. Thanks to tireless efforts of some individuals and NGOs, mental health has received some attention of political parties and policymakers. But it is still not part of a national debate this issue so truly deserves.
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