Break Mental Health Stigma

Think about the last time you felt overwhelmed and anxious. We generally associate them with someone going through a difficult phase in their life. But for many, these feelings are more than just bad days; they’re part of a bigger inner battle that deserves a lot of attention. Given that our mental states dictate so much of our lives, mental health becomes a significant part of our emotional, psychological, and social health.

However, mental health remains under the shadows of stigma and misunderstanding in Nepal, which requires immediate action. According to various studies, poor mental health is the result of stigma and cultural barriers. In Nepali culture, the mind and the body are considered distinct entities, and mental challenges are viewed differently from physical illness. Mental illness is mostly seen as spiritual dysfunction, a weak mind, and it is also considered to be the illness of the rich.

Due to such widespread stigmatisation, people hesitate to open up about their challenges with mental health. And, when people hesitate to talk, it adds to the notion that the topic is taboo. This prevents patients from seeking timely help and causes dropout in the treatment of mental health problems.

We also have a strong belief in traditional healing, and the first point of contact for most people is religious or faith healers (e.g., dhamis, jhankris, baidyas, lamas, and bijuwas). The doors are often closed for medical communication because of discrimination and social exclusion.

Alongside this challenge, the pressure to maintain family honour causes one to become secretive and live in denial. Hence forbidding them from seeking consultation about these illnesses. These kinds of barriers worsen a person's situation, due to an increased struggle to find access to suitable treatment, with outcomes of increasing conditions and persistence of disorders. And one important point of consideration is that people don't want to add societal pressures while already dealing with mental illness. In our society, the victims often find difficulty in finding jobs or even finding a life partner when having some mental illnesses such as anxiety, eating disorders, depression, post-traumatic stress, and other disorders.

The prejudice and discrimination felt by those with mental issues might lead to believing in negative stereotypes, resulting in feeling shame and guilt. When there is a delay, without adequate counselling and medications, the patient's health worsens.

COVID-19 has also added more fuel to this problem. Due to lockdowns and social distancing, deep loneliness and isolation developed in people's minds, affecting their well-being. Disrupted daily routines, minimal social interactions, and fear for health and safety impacted mental health, and that has caused increased levels of stress, depression, and emotional strain on people.

Now, long after the pandemic is over, addressing these mental health concerns has become increasingly important, as individuals struggle with both the immediate effects of the crisis and its long-term consequences.

According to data published by the Epidemiology and Disease Control Division (EDCD), suicide rates have surged by a staggering 72 per cent over the past decade. Among different factors, mental health issues stand out the most.

A report from the World Health Organisation (WHO) shows that Nepal has just 0.17 psychiatrists, 0.03 psychologists, and 0.21 mental health nurses per 100,000 people. This is significantly lower than WHO’s recommendation of at least one mental health worker for 10,000 people. This alarming discrepancy highlights the inadequate mental health services available to the people, making it harder for individuals who have difficulty accessing the support and assistance they need. The shortage is contributing to a growing mental health crisis in Nepal, which is further exacerbated by stigma and limited awareness of mental health issues.

It is crucial for the concerned authorities to focus on increasing the number of well-trained mental health professionals by offering specialised training programmes. 

Strengthening the mental health infrastructure in rural areas is also vital to ensure that mental health services are accessible for all. Additionally, new public awareness campaigns and government funding for mental health initiatives are essential.

(Khanal is pursuing higher education.)