KATHMANDU, June 29: Children are cherished and acknowledged by their families, and friends wherever in this world. Their amicable smiles radiate warmth and bring happiness to people around them, creating a vibrant image of happiness and contentment. However, beyond this facade lies a vulnerable population that often gets misunderstood. Adolescents often struggle with their silent battles, trying their hardest to present an image of success despite fighting their inner demons. It is unfortunate that many of these stories remain untold as these individuals continue to wrestle with their struggles in isolation, obscured in the darkness.

According to the World Health Organization (WHO), globally, one out of every seven individuals between 10-19 years of age experiences a mental health disorder. Furthermore, it is found that 13 percent of the global burden of mental health disorders falls in this age group. Suicide is the 4th leading cause of death among 15-19 year olds. Still, the mental health of adolescents remains largely unrecognized and untreated. 

The signs and symptoms are often neglected or ignored. Adolescents with mental health conditions are vulnerable to social exclusion, discrimination, and societal stigma and they often engage in life-threatening behaviors like smoking, drinking, and drug abuse. There are several reasons why adolescents have become the primary target of these mental health disorders, such as peer pressure, social media influence, gender, and societal norms that further exacerbate the differences between an adolescent’s reality and their hopes and dreams for the future. 

More than half of the mental disorders in adulthood begin in either childhood or adolescence. Individuals are vulnerable to these disorders during adolescence. The body and mind of a teenager undergoes a myriad of changes. Their mind begins to develop and they experience various kinds of unfamiliar emotions and feelings due to the hormonal and psychological changes in their body. 

Teenagers often strive for independence and seek freedom from their parents and homes. They end up engaging in rebellious activities mostly under peer pressure or as a way to cope with the challenges they face in their daily lives. They experience strong and intense emotions thus making them emotionally sensitive and vulnerable. Adolescents sometimes feel the need to detach themselves from their surroundings and indulge in solitary activities, which may have negative effects in the future. Adolescence is often perceived as a challenging stage that is delineated by stubbornness, recklessness, moodiness, and emotional instability.

Adolescent mental health is regarded as an umbrella term that covers various conditions such as anxiety, depression, substance abuse, obsessive-compulsive disorder (OCD), and eating disorders like anorexia and bulimia, which are mostly common in women. Adolescents struggling with mental health issues may be at a higher risk of developing different types of mental disorders as they progress into adulthood. 

The situation of adolescents regarding mental health in Nepal is no different than in the rest of the world. A survey conducted by UNICEF in 2019 shows that in Nepal, 24.19 percent (26.5 million) fall under the 10-19 years age group. Among them, over five percent adolescents are suffering from mental health disorders. Forty percent of the current population consists of citizens younger than 18 years, therefore putting a large number of the population at risk of these mental health issues. Conditions like Post-traumatic stress disorder, Autism Spectrum Disorder, Anxiety, and Attention Deficit Hyperactivity Disorder are very common among the youth population in Nepal. According to the 2022 Nepal Demographic and Health Survey, 22 percent of women and 11 percent of men aged between 15-49 reported experiencing symptoms of anxiety and other similar conditions. 

Several cases of mental health issues go undetected or neglected. In the Nepali culture, mind and body are considered two different entities and if a person is dealing with a mental health condition it is perceived as a ‘Spiritual dysfunction’, especially in rural areas where a large population is uneducated. Therefore people visit traditional healers who have no formal training or education regarding dealing with  mental illnesses. Youths are often hesitant to discuss their concerns associated with mental health due to fear of discrimination, and rejection from friends and family. The Department of Health Services stated that at present, only 0.36 psychiatrists are working in the health sector per 100,000 people. Moreover, only one out of four people who require mental health services in Nepal are able to access the resources effectively. 

Since mental health is not yet considered a pressing issue, there is a lack of awareness and education among people and communities. 

In 2019, Nepal expanded its National Health Policy to include a strategy that incorporates mental health services into health care systems. The government educational institutes should initiate various susceptibility programmes designed for child adolescent and forensic psychiatry. To further prevent unfortunate cases of suicide and self-harm, a mechanism for suicide reporting and surveillance can be developed. A greater focus on assessing developmental distress in adolescents will eventually open up a better understanding of mental health disorders. 

The government's implementation of these policies alone is insufficient to raise awareness about mental health. Youths should engage in conversations with their parents, school counselors, and friends about their problems. A healthy and safe environment should be created so that individuals won't be hesitant to talk to the people they trust. This is a combined effort that involves both family members and children. 

Discussions on mental health are not just meant for the individual’s well-being, but for the entire society’s benefit. Addressing the challenges and setbacks faced by youth and detecting the signs and symptoms of mental health conditions is imperative.  Creating a free and secure environment for youths can be helpful, so that they can talk about their mental health without any kind of doubts or hesitation. To achieve that, a combined effort must be made by everyone– families, community, healthcare sectors and the individual themselves. Like everyone else, adolescents deserve to flourish mentally as they pave their path towards adulthood. By providing an amiable and understanding environment, adolescents can overcome obstacles and challenge themselves to be an individual with immense potential in the society.