Amid growing calls for prioritisation of mental wellbeing, Nepal’s health authorities are planning to upgrade mental health services in at least two (yet to be named) hospitals. The goal is to ensure private consultation rooms where patients can talk fearlessly without being overheard, where trained psychiatrists and nurses can treat the patients with special care, and to arrange necessary medications at hospitals. This is welcome as Nepal not only lacks hospitals that provide specialised or basic mental health care, but even those that offer such care often don’t have an environment conducive to the needs of the patients, including separate rooms and privacy. Private consultation rooms can help bring a sea change as social stigma, entrenched discrimination and humiliation are major barriers to seeking mental health care in Nepal.

But at a time when mental health problems are rising alarmingly and major interventions are vital in all mental health care institutions across the country, upgrading services at two hospitals will only scratch the problem’s surface. According to the World Health Organisation (WHO), one in every eight people lived with a mental health problem in 2019, and this number increased during the Covid-19 pandemic. A National Mental Health Survey-2020 conducted by Nepal’s National Health Research Council shows that of 15,088 people surveyed (9,200 adults of 18 years and above, and 5,888 adolescents), 5.2 percent of those aged 13-17 years had a mental disorder, with neurotic and stress-related disorders most common among them.

Similarly, among adults, while 10 percent had a mental disorder at some point in their life, 4.3 percent were found battling with it in the research period (2017-2020). The WHO also estimates that in Nepal, mental illness makes up 18 percent of all non-communicable diseases. Data from Nepal Police paints an even more alarming picture—in the fiscal year 2023-24 alone, 7,223 people died by suicide, following 13,823 suicides in the previous two fiscal years.

Despite the high prevalence of mental health problems, successive governments have fallen way short of addressing them, with only 1 percent of the health budget set aside for mental health. Nor are there enough mental healthcare workers. The country has only 0.27 nurses, 0.13 psychiatrists, and 0.02 psychologists per 100,000 people. New initiatives like the provision of private consultations for those with mental health problems are a good start. However, while the health officials acknowledge the necessity of extending such services to other hospitals that provide mental health services, they point to a lack of budget to do so.

Nepal cannot make a serious dent in its mental health crisis without allocating a significant portion of its national budget for the health sector—and mental health in particular. But sadly, the Ministry of Finance has set a health budget ceiling of Rs83 billion for the upcoming fiscal year, which is Rs3 billion less than the amount allocated for the Ministry of Health and Population in this fiscal year. This is not enough to meet the already struggling sector. Much more is needed to provide equitable care across the country.

Mental disorders and related deaths can be prevented with the right policies and interventions. The mental health crisis must be treated with the seriousness it deserves and no patient should be left behind.