The concept of mental health extends beyond the mere absence of mental disorders, encompassing a wide range of factors. It is essential to consider various aspects of mental well-being to understand and address mental health issues and challenges truly. According to the World Health Organization (WHO), mental health includes a variety of mental disorders, psychosocial disabilities, and other mental conditions that can lead to distress, impede normal functioning, or pose a risk of self-harm. Individual psychological and biological factors, such as emotional skills, substance use, and genetics, can heighten susceptibility to mental health issues. In addition, unfavorable social, economic, political, and environmental circumstances can also increase the likelihood of experiencing mental health conditions. Therefore, mental health is a fundamental human right for all individuals. Everyone, regardless of who they are or where they are from, has an inherent right to the highest achievable standard of mental health.
The 2022 global statistics on mental health are concerning. It is estimated that around one in seven individuals aged 10-19 are facing a mental disorder, accounting for about 13 percent of the global burden of mental health disease within this age group. Specifically, anxiety affects approximately 284 million people worldwide, while depression affects 264 million. In addition, alcohol use disorder impacts 107 million people, drug use disorder affects 71 million, bipolar disorder affects 46 million, and schizophrenia affects 20 million. These figures highlight the significant and widespread impact of mental health disorders globally, affecting diverse populations regardless of boundaries.
Nepal’s Ministry of Health and Population has prioritized “promoting mental health and well-being.” It has actively collected data on mental health in its two most recent surveys: the 2022 Nepal Demographic and Health Survey and the 2021 Nepal Health Facility Survey. According to these surveys, 22 percent of women and 11 percent of men aged 15-49 reported symptoms of anxiety, while five percent of women and two percent of men reported symptoms of depression. Studies also indicate that migrant workers and their families experience higher levels of depression and anxiety. Dr Arun Raj Kuwar, a child and adolescent psychiatrist, has highlighted that 33 percent of Nepal’s population under 18 is affected by mental health issues. An analysis of suicide reports by Nepal Police for the period 2015-2019 revealed a total of 25,316 cases of suicidal death in Nepal. On an average, there were 14 suicides each day, with individuals aged 19 to 35 years accounting for almost 60 percent of all suicide deaths. The analysis also showed a 33 percent increase in suicidal deaths in 2019 compared to 2015, with a significant 200 percent increase in females. Hanging was the most prevalent method (70.13 percent), followed by the consumption of poison (26.55 percent). If a mental health condition significantly affects daily activities for an extended period, it can be considered a disability. Adults with disabilities report experiencing frequent mental distress almost five times as often as adults without disabilities (CDC).
The Mental Health Act was established in 2006 following the restoration of the House of Representatives in Nepal to prevent, control, and care for the growing mental health challenges in Nepal. Its primary purpose is to ensure prompt care for mental disorders and safeguard the rights of individuals facing mental health challenges. The 2015 Constitution of Nepal guarantees every person’s fundamental right to live with dignity and access healthcare. Nepal’s National Mental Health Strategy and Action Plan (2020) outlines the country’s mental health care plans, including free primary care mental health services nationwide. The policy aims to prioritize mental health, prevent disorders, and ensure affected individuals receive high-quality, culturally appropriate care in a timely manner.
Over the past year, Nepal has demonstrated a significant commitment to addressing its mental health challenges. A workshop held in Kathmandu on April 28-29, 2024, was instrumental in advancing the integration of mental health into the maternal health program. This initiative involved the Family Welfare Division under the Ministry of Health and Population (MoHP) and the WHO Country Office for Nepal. At the provincial level, the Karnali Mental Health Program, with the support of CBM Global, is being implemented in ten rural municipalities across Surkhet, Dailekh, and Western Rukum districts from March 2023 to February 2026. Additionally, the First International Conference on Community Mental Health, held in Jumla, Karnali, on May 4-5, 2024, played a pivotal role in promoting community mental health. This milestone event was organized by the Karnali Academy of Health Sciences (KAHS) in collaboration with the Harvard University Massachusetts General Hospital Psychiatric Department, USA, and the Ministry of Health and Population.
During this period, non-governmental organizations (NGOs) and community-based organizations (CBOs) across the country coordinated a wide range of activities. On May 24, 2024, the NGO Youth Lead released a comprehensive report entitled “Advancing Mental Health Services for Young People Who Use Drugs in Nepal.” Several years back, CWIN Nepal partnered with the Ministry of Health and Population and FORUT Norway to establish the first Child and Adolescent Psychiatry Unit at Kanti Children’s Hospital in Nepal. This initiative subsequently expanded to encompass Lagankhel Mental Hospital. A significant development this year was the launch of “Ma Chhu Ni,” a chatbot for Tele Mental Health on Facebook. The chatbot is designed to assist in coping with stress, addressing various situations, understanding users’ needs, and offering appropriate support. Moreover, the Adolescents National Networks of Girls and Boys actively engaged in discussions on mental health issues and challenges during national conferences and consultations. The Child Helpline (1098) provides essential information and counseling services to vulnerable children online, while the National Helpline (1166) for Suicide Prevention offers counseling services for mental health patients dealing with suicidal thoughts as part of prevention and control efforts.
Furthermore, phect-Nepal’s program on “Community Based Reproductive Health and Counseling Center (CBRHCC)” provides free psycho-social and legal counseling to raise awareness about reproductive health among children and adolescents. In May 2024, several NGOs and CBOs, including KOSHISH, which works in mental health sector, observed Mental Health Awareness Month with various programs. With financial support from UNICEF Nepal and technical assistance through CWIN Nepal, CMC has been implementing the Integration of Child and Adolescent Mental Health Services in Primary Health Care, Karnali Province (21st September 2023 till 31st December 2024) in 4 Municipalities (Gurbhakot, Panchapuri, Bheriganga and Birendranagar) of Surkhet district.
A comprehensive approach is necessary to safeguard mental health and effectively address individuals’ diverse challenges. Parents, schools and the community can play an active role in promoting young individuals’ mental health and well-being.
Recognizing the significance of mental health as a fundamental human right in advancing public well-being is imperative. The right to accessible, affordable, and sustainable mental health services is essential for improving quality of life and building resilience to face life’s challenges. However, the current services for those in need are insufficient and do not meet essential quality and standards. Therefore, reshaping our physical, social, and economic environments is imperative to create spaces that prioritize mental well-being. For this, a comprehensive approach is necessary to safeguard mental health and effectively address individuals’ diverse challenges. Moreover, the active involvement of parents, schools, and the community is essential in promoting young individuals’ mental health and well-being. Service providers can engage families in conversations about effectively connecting, fostering open communication, and monitoring their activities and health behaviors. Therefore, collaboration between governmental agencies and a diverse range of partners, including UN agencies, NGOs, CBOs, and INGOs, is vital to translate plans of action into reality and to address and improve the socio-economic, cultural, political, environmental, and developmental factors that significantly impact mental health on a broader scale.
Gauri Pradhan is a human rights defender associated with Public Health Concern Trust (phect-NEPAL).
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