Recent studies suggest a close link between physical and mental health. Poor mental health is now a proven culprit in exacerbating physical ailments, everything from cardiovascular to bone diseases, and in suppressing the body’s inbuilt immune system. According to the World Health Organization, mental illnesses are now responsible for 37 percent of healthy years lost from all non-communicable diseases globally. The estimated cost of mental illnesses to the global economy in 2010 was a staggering US $2.5 trillion, which is projected to top US $ 6 trillion by 2030. Although no comparable studies have been carried out to evaluate the medical and economic costs of mental illnesses in Nepal, the impact is likely to be as big. Informal estimates suggest three out of every 10 Nepalis suffer from some mental health condition in the course of their lives, while five percent of the country’s population has severe mental health problems.
One would think that a problem of such magnitude would receive serious government attention. But that does not seem to be the case: at present, a shameful 0.14 percent of the national health budget goes to mental health. There are only 171 beds for psychiatric patients within the Kathmandu Valley, including both government and private hospitals; and of the 75 districts, only 10 have psychiatric treatment facilities.
The number of trained manpower in the field is abysmally low as well: one psychiatrist for every million people. Like with the availability of mental health facilities, most of the trained manpower in the field, as few as they are, are concentrated in the urban hubs, leaving a huge swath of population out of reach of mental health services. The tragedy is that even the available resources have not been used optimally, owing to the great stigma attached to mental illness. Only by fostering a climate of openness and acceptance will things begin to change.
Informal estimate suggests three out of 10 Nepalis suffer from some form of mental health condition in the course of their lives.
Half the battle will be won if people come to see mental illness as no different from any other bodily disease. Nepali women suffer disproportionately from mental health problems due to the social restrictions placed on them. A 2009 government study found that suicide was number one cause of death among women aged 15-50. Another population cluster disproportionately affected by mental illness is that of conflict-era victims. Time is ripe to come up with programs tailor-made for these specific groups.
There are big obstacles to be overcome for the creation of a mentally healthy society. Up until now there is no mental health act at the national level, while laws still prevent people with mental disorders from voting and standing for public office. There is a systemic victimization of mental illness sufferers. Such trends will be hard to reverse overnight, but encouragingly, grassroots and NGO activism is starting to bear fruit in terms of greater awareness of the problem. The country is on the brink of another historic Constituent Assembly polls and the hope is that the all-important issue of mental health will get more attention in the new constitution. One thing is clear: only concerted and sustained efforts of state and non-state actors will bring the desired changes.
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