Talking about mental health problems is no longer the taboo it once was. That does not mean it’s easy. That does not mean that if you have a mental health issue, you will find someone with the requisite knowledge and empathy to talk to. And that does not mean the situation is the same in every part of Nepal. At least in urban areas more people have started to talk about their mental health problems with less shame. This is evident in the growing trend of visiting psychiatrists and counselors, in the understanding that mental health diseases like anxiety and depression are no different to other physical ailments that can, under the right conditions, be treated with medicine. But even though the number of these people who know they have problem and seek help is growing, they are still in the minority. The majority of those who know something is wrong—and it’s easy to do so in the age of mass media and Google—try to play it down, to trick themselves that they can will themselves to overcome whatever troubles they have.
They keep deferring treatment, on one pretext or the other. And they pay for it. They destroy their careers, wreck relationships and harm their health. And when it gets overwhelming, many decide to take their own lives. This is why Nepal today has among the highest suicide rates in the world. But while the problem might be especially acute in Nepal, its scope is global. The World Health Organization thus decided to mark the World Health Day on April 7 with the theme of “Depression: Let’s talk”. According to it, around 300 million people, of all age groups, suffer from depression around the world. As is the case elsewhere, more women than men suffer from depression in Nepal. Young Nepali women are especially vulnerable, not just to depression but also to suicide. It’s partly a genetic thing. But a larger explanation for the mental anguish of Nepali women is their socio-cultural marginalization. Having been married young and having internalized their ‘inferior’ status in male-dominated relations, most wives silently suffer physical and mental abuse of their husbands, for years on end. And it’s still rare in Nepal to be counseled on postpartum depression.
As the WHO’s slogan this year suggests, if we could only talk more about it, in more parts of the country, those suffering will also be more likely to get the kind of help they need. But that is not enough. If someone has acute anxiety or depression, that person should also be able to get help close by and in the desired privacy. For this it is important to train more mental health professionals and deploy them widely, for instance in the hospitals that are to be established in each of the new 744 local level units. Since mental and physical health are inextricably linked, it would be foolish to emphasize one while neglecting the other. It is with this principle that all our new health institutions should be established and operated.