By Nayak Paudel
Kathmandu, Sept. 23: A summary report published by the Nepal Health Research Council (NHRC) of the National Mental Health Survey, Nepal-2020 shows that adults with mental disorder faced several instrumental, attitudinal and stigma-related barriers to access professional mental health care.
Planned from 2017, the National Mental Health Survey was conducted from January, 2019 to January, 2020 among 15,088 individuals. Among the participants, 5,888 were adolescents aged 13-17 years and 9,200 were adults aged 18 years and above.
The NHRC conducted the first ever mental health survey and collected data through socio-demographic questionnaires, translated and adapted Nepali version of MINI International Neuropsychiatric Interview 7.0.2 for DSM-5, pathways to remove care/help seeking behaviour questionnaire and Barriers to Accessing Care Evaluation (BASE) questionnaire.
“The survey was a need for health authorities to come up with effective plans and policies to improve the country’s mental health sector. We have published a summary report for now and a detailed report will also be published soon,” said Meghnath Dhimal, senior research officer at the NHRC and a member of the survey team. The summary report shows that 10 per cent of adults had some form of mental disorder in their lifetime while 4.3 per cent were currently suffering from mental disorder.
Around 40 per cent of adults were found to have talked about their symptoms to someone, including spouse (20.5 per cent), other family members (22.4 per cent), friends/neighbours (15.3 per cent) and health service providers (3.5 per cent).
Similarly, among the individuals with symptoms for mental disorders, the rate of visiting professional health service providers was low.
As per the report, among the adults with mental disorders, 6.5 per cent visit psychiatrists, 8.8 per cent visit non-specialist doctors and 6.7 per cent seek faith healers for treatment. “There are barriers caused by various aspects of the society obstructing individuals with mental disorder to seek care and treatment. Some of the barriers are instrumental, attitudinal and stigma-related,” said Dhimal.
The instrumental barrier’s section of the report shows that 24.9 per cent were unsure as to where they should go to get professional care, 19.5 per cent could not afford financial costs, 14.7 per cent had difficulties taking time off work, 11 per cent had problems with travelling to appointments and 10.5 per cent expressed they had no one to help them get professional care.
Regarding attitudinal barriers, 47.4 per cent wanted to solve the problem on their own, 48 per cent thought the problem would get better by itself, 45.9 per cent believed they had no problems, 16.8 per cent preferred alternative forms of care and 16.7 per cent thought professional care would not help.
Similarly, stigma-related barriers also prevent adults from seeking quality mental health care and counseling such that 15.6 per cent were concerned that having mental health problem would show him/her as weak, 12.3 per cent were concerned about family’s feeling, 11.7 per cent felt embarrassed or ashamed, 10.5 per cent feared to be seen as ‘crazy’ and 9.7 per cent were afraid if people would take them seriously.
“Every barrier has obstructed respective individuals to a certain degree in seeking care from the professionals. These barriers need to be mitigated with the help of proper awareness and by making mental health services accessible throughout the country,” Dhimal said.
Talking to The Rising Nepal earlier, Psychiatrist at Mental Hospital Dr. Basudev Karki had said that the authorities should increase awareness programmes and make mental health counseling accessible to all.
“Mental health, if neglected, can lead an individual to take wrong steps. Forming effective policies based on proper research would help the authorities strengthen mental health sector and improve the health of the country’s manpower,” said Karki.
With a detailed report in pipeline, NHRC and mental health experts have been looking forward for authorities to come up with proper action plans and strategies to remove the barriers. Some days ago, Prime Minister KP Sharma Oli had met with mental health experts and assured of improving mental health sector.