A 19-year-old woman from Chinali village in Bagchaur Municipality of Salyan district recently went missing for more than 12 days. She was heavily pregnant at the time of her disappearance. 

When she was found by her relatives, she was not in a bad emotional state. Her in-laws then took her to Bankhukhola Health Post for a medical check-up. 

“The woman was suffering from antepartum depression [depression during pregnancy],” Nirmala Oli, a staff nurse at the health post told the Post over the phone. “I counselled her and her in-laws regularly. Now her condition is normal and she is due to give birth sometime next week.”
The case of the young woman from Chinali village is just one illustration of mental health issues that afflict many people, particularly in rural areas where access to proper mental health care is hard to come by. The government records show that the number of patients seeking mental health care has been rising in rural districts of the country. 

Nepal simply does not have enough experts to treat and cure mental health problems. There are only around 130 psychiatrists in the country, most of whom are based in urban areas; fewer than 30 of them work for the state-run hospitals. Concerned by the mental health crisis in the country, the government has started to train paramedics and staff nurses in mental health issues to bridge the gap in service delivery.

With the training, officials believe, the health workers may be able to address the needs of patients suffering from mental illness.

This Ministry of Health and Population initiative began last year. Oli was one of over 1,000 paramedics and staff nurses from 20 districts who underwent the training. Without the training, Oli would not have been able to diagnose the condition of the young woman from Chinali. 

Trained health workers like Oli have been helping patients of mental illness in other parts of the country as well. 

Purnima Poudel, a staff nurse at a health facility run by Health Foundation Nepal, a non-governmental organisation in Dang district, said that she had dealt with 29 mental health cases in the last 19 days. 

“A number of people living with mental health problems come to us for counselling, and I have referred about half a dozen of them to the psychiatric doctor,” Poudel, told the Post over the phone.

Encouraged by the results, the Health Ministry is preparing to train more health workers this year. 

The new approach is complemented by the government’s continued commitment to providing free medication to mental health patients up to the health post level and keeping several medicines of mental health on the list of essential medicines which are distributed free of cost. 

“We are planning to provide mental health training to over 1,000 paramedics and staff nurses of 21 districts this year,” said Dr Phanindra Baral, chief of mental health section at the Epidemiology and Disease Control Division. “The training will help screen the mental health patients in rural areas and recommend severe cases to consultant psychiatrists.”