Mental health is often not taken seriously in Nepal. Due to the deep-rooted stigma, many silently suffer, often without even realising they need help. The challenges continue even when people seek support, as institutions often fail to provide the promised care. As a result, people’s trust in institutions has been eroding. This also creates a social divide, as only the ones who can afford expensive, private treatment may recover. Considering these issues, the Supreme Court has delivered a much-needed verdict acting on a Public Litigation filed by an NGO working on mental health, directing the government to reform the nation’s mental health policies and services. This is encouraging.

Among the issues raised by the PIL was the poor implementation of the National Mental Health Policy of 1996. The policy sought to guarantee equitable access to basic mental health services for all citizens, promote the development of mental health professionals, safeguard the rights of individuals with mental illness, and enhance public awareness. It also recommended the creation of a dedicated mental health division within the Ministry of Health. But many hospitals lack such services altogether, and proper facilities and trained service providers are often absent among those that do claim to provide them. So when the top court issued directives concerning the enactment of mental health legislation, the Ministry of Health responded that it has neither the budget nor a trained workforce to implement the order in this fiscal year.

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 means that while the Non-communicable Disease and Mental Health Section of the Epidemiology and Disease Control Division had around Rs47 million to spend this year, the budget ceiling given to them for fiscal year 2025-26 is Rs35 million. This kind of budget cutting doesn’t make sense in a country where one in eight people live with a mental health condition. Further, the prevalence of mental health issues is rising. The National Mental Health Survey Nepal reported that 5.2 percent of adolescents suffered from mental disorders, with approximately 4 percent experiencing suicidal thoughts and 0.7 percent having attempted suicide. Three years later, according to data from the Nepal Police, 7,223 people died by suicide in the fiscal year 2023–24, following a total of 13,823 suicides in the previous two years (2021–22 and 2022–23).

Lately, many health initiatives, like the Safe Motherhood Programme, are at risk of being badly hit due to the budget crunch. The same thing cannot happen to mental health. With international funds drying up, prioritising vital areas like the nation’s mental well-being has become even more critical. The Ministry of Health should thus see the Supreme Court’s directive as a chance to pitch for more government funding. Even if budget constraints make it difficult to provide free primary treatment, there should at least be a firm commitment to offering mental health awareness programmes that are accessible to all, enabling individuals to manage their mental well-being to an extent. The Supreme Court has shown the way; it is now up to the government to act with the needed urgency.