When the whole world was celebrating World Mental Health Day on October 10 with the theme, “Living with Schizophrenia”, there was no formal celebration of the day in Nepal. Upon inquiry, I found just one or two programs held by international organizations. This lack of celebration made me curious about the mental health status in Nepal. It was depressing to know that around 20-30 percent of Nepal’s population suffers from some sort of mental illness. It’s more unfortunate to know that maximum number of these people even don’t know about their own mental state or illness.
Since no exact statistics on the number of people suffering from mental illness in Nepal is available, it’s clear that mental health is a neglected sector. Major mental diseases observed in Nepal are depression, bipolar affective disorder, and schizophrenia among others. Seventeen percent are suffering from depression and the victims are mostly females. Maternal Mortality and Morbidity Study 2008/2009 conducted by Family Health Division (FHD) of the Department of Health reveals that suicide is the number one cause of death for Nepali women. Depression generates suicidal tendencies in people. One percent lives with schizophrenia.
Psychiatrist Mausami Thapa of Nepal Medical College says that around 30 percent of people approaching the hospital have mental problems. Since this hospital is located in the city area, we can imagine that the visitors have some knowledge or concern about mental health. At least they desire to share their mental problem with psychiatrists. What about hundreds and thousands of people in rural areas, who can’t even identify or share their mental state with experts? There are no sufficient mental health centers and psychiatrists in all districts as most of them are centered in the capital. This has led to a serious problem in the mental health sector. Due to the fear of social stigma, people are less interested in sharing or discussing about their mental problems. Even if they want to share, mental health centers and professionals are in short supply.
Our lack of the knowledge of mental health makes us unsympathetic to people suffering from psychiatric problems. In our daily life, we often call people performing unusual activities as “psycho” or “mad”, without knowing their actual problem. Mental illness is definitely not only the result of psychological factors as we generally assume. Basically, there are three major reasons behind mental diseases. The first is biological, identified by some abnormality in neuro-transmission like the lack of dopamine or serotonin. Even head injury is included in it. The second is psychological, related to the disorder in mind. The third is sociological, related to inter-personal relationship, family support system and the social environment. Medical intervention is required in a patient only after proper diagnosis.
Trauma, grief, financial troubles, and unemployment are some of the reasons that cause depression. During the Maoist insurgency many people had to go through traumatic experiences. Many people suffered from post-traumatic stress disorder. Some of them were lucky to receive psychiatric help while many are still bearing the mental scars. Other reasons for mental illness are SLC results (leading people to commit suicide in failure). Unemployment is fast becoming a cause for depression in Nepali youths.
On the Mental Health Day, I visited a rehab center named “Maryknoll” aka “Ashadeep” in Sundarijal. I found the condition of the rehab center depressing. The private center, established 20 years ago, starting with the rehabilitation of mental patients incarcerated in the central jail, has given a new life to hundreds of people. It has been the hope of light to many mental patients. But now it’s not even in a stable condition to serve more people in lack of funds. It lacks the support from the government or I/NGOs. Currently, there are 28 residential mental patients in the center, among which 11 are females. Some are left alone, whereas some are regularly visited by the family members. Patients have been treated in a warm environment by the center, easing them to cope with the dehumanized condition.
It was really a moment of delight to observe those mental patients smiling, walking around, being active in playing cards and carom, reading newspapers, gazing cows, playing swing and interacting with each other. They are living like a family sharing all the highs and lows of life together. But again, the bitter reality is that they may not enjoy the same environment for long. Manager Kumar Dahal shared that they are even thinking of handing over the center to the government in lack of budget. There are also few other rehab centers in the capital struggling to operate or exist in lack of funds.
Mentally healthy citizens can contribute to nation building. But it’s unfortunate that the government has allocated less than one percent of total budget for the mental health sector. Due to the lack of awareness, people don’t know about the importance of check-up or sharing mental problems. For this, awareness should be raised from the grassroots. The ritual of conducting conferences or holding rallies in the capital doesn’t count.
Additionally, the government must conduct free mental health camps regularly across the country, including in rural areas. More rehabilitation centers for the people with mental problems should be opened. Few private rehab centers are in operation but they lack funds for daily management. They should be provided with adequate funds. Raising the awareness about the importance of mental health, people should be encouraged to share about their mental state.
Published on Republica, 2014-10-21 00:34:08
http://www.myrepublica.com/portal/index.php?action=news_details&news_id=85178
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