After a failed effort to deploy psychiatric doctors at the state-run health facilities to screen mental health patients, the Ministry of Health and Population is preparing to mobilise trained staff nurses and paramedics for the job.

This year, the ministry has been providing training to over 1,200 staff nurses and paramedics from 21 districts.

"This is the second consecutive year we have been providing training to screen mental health patients," Dr Phadindra Baral, chief of the Mental Health Section at the Epidemiology and Disease Control Division, told the Post. "We will train junior health workers—staff nurses, paramedics—in all 77 districts by the next fiscal year."

Experts at Nepal Mental Hospital in Lagankhel have been imparting training to the health workers. Over 1,000 staff nurses and paramedics from 20 districts were trained last year.
The division has allocated Rs 65 million for the training of the health workers. The division has also allocated a budget to buy medicines for mental health patients.

Nepal does not have enough experts in the field of mental health. There are only around 130 psychiatrists in the country, most of whom are based in the city areas and fewer than 30 of them work for the state-run hospitals.

According to the World Health Organization, the total number of human resources working in mental health facilities or private practice per 100,000 population is 0.59. The breakdown according to the profession is —0.13 psychiatrists, 0.06 other medical doctors, 0.27 nurses, 0.02 psychologists and 0.010 other health or mental health workers.

"Production of psychiatric doctors is very low in general, and very few are serving in government service," said Baral. "It will be very difficult to deploy mental health experts in districts. So we are training staff nurse and paramedics."

Dr Ananta Prasad Adhikari, a consultant psychiatrist at Nepal Mental Hospital, said the training programme was an excellent initiative taken by the health ministry.

"Trained health workers can easily screen the mental health patients and refer them to advanced centres," said Adhikari. "Patients will be diagnosed in their nearby health facilities in early-stage and get proper treatment."

Apart from imparting training to junior health workers, the division has also included medicines of mental health on the list of essential drugs.

The division has also allocated budget for awareness programme to minimise suicide rates and for rescue and rehabilitation of the mental health patients.

A recent pilot study by Nepal Health Research Council shows that around 13 percent population have been suffering from mental health problems—major depressive disorder, alcohol use disorder, substance use disorder and dissociative conversion disorder. The study shows that with any form of mental disorder, only 18 percent received treatment in the last 12 months.