On Saturday, 38-year-old Bhagwati attempted to kill herself at her home in Dolakha. Her children yelled for help. But by the time neighbours arrived, she was already unconscious. She was rushed to the district hospital, which referred her to Kathmandu as her condition was critical.

"She was brought to our hospital on Sunday morning," Dr Basudev Karki, a consultant psychiatrist at the Nepal Mental Hospital, told the Post. "Her condition remains critical."

Karki said Bhagwati had been under stress after her husband lost his job during the lockdown. The family was under pressure to repay their loan and Bhagwati was especially worried about being unable to provide for her children, according to relatives.

The Covid-19 pandemic and the nationwide lockdown, enforced since March 24, are taking a toll on the mental health of people, triggering new issues while exacerbating existing ones, say public health experts.

In a number of cases, these issues culminate in people taking their own lives, they say.

During the first 74 days of the lockdown, 1,227 people (16.5 a day) across the country have ended their own lives compared to 5,785 (15.8 a day) in all of last year.

Doctors say the lockdown has brought changes to the lives of people as they live in fear of contracting Covid-19. People are interacting with each other far less than usual, many have lost their jobs, and are struggling to repay their loans. An overall increase in economic burden is leading to a rise in anxiety, stress and depression, they say.

“This could be just the beginning as a lot of people are under a lot of stress,” said Dr Kamal Gautam, executive director at the Transcultural Psychosocial Organization, a mental health organisation.

In some cases, even minor issues have had serious consequences.

Last week, a 12-year-old boy in Kirtipur attempted to kill himself following an argument with his father who was angry about him playing video games and watching television all the time, said doctors. The boy was rushed to the Nepal Mental Hospital.

"The boy was in a critical condition. Doctors had to admit him into intensive care for four days," said Karki, "He is recuperating now."

During high stress situations like pandemics, natural disasters, and wars, mental health problems are known to affect people, said Gautam. Cases of disorders such as depression, anxiety, psychosis and schizophrenia tend to increase significantly, sometimes at rates of three to five percent, he said.

The issue of mental health during the pandemic has come to the forefront not just in Nepal, but also around the world. “The impact of the pandemic on people’s mental health is already extremely concerning,” said Dr Tedros Adhanom Ghebreyesus, director-general at the World Health Organization. “Social isolation, fear of contagion and loss of family members is compounded by distress caused by loss of income and often employment.”

The UN health agency said that Covid-19 pandemic highlights the need to urgently increase investment in services for mental health or risk of a massive increase in mental health conditions in the coming months.

The lockdown, which until recently prohibited all public movement, only contributed to aggravating mental health as people with pre-existing conditions were unable to receive counselling or medication, as many mental health doctors have asked patients not to visit health facilities, unless in case of an emergency.

"This has meant that patients were unable to get new prescriptions and in most cases, pharmacies do not give out psychiatric medicine without a doctor’s prescription," said Gautam.

Government officials said that they were aware of the risks to mental health and were actively attempting to take countermeasures. Dr Phanindra Prasad Baral, chief of the mental health section at the Epidemiology and Disease Control Division, said that the division has asked health facilities across the country to provide medicines for a minimum of 15 days to a month as patients are unable to visit health facilities frequently.

There are also a number of helplines, run by both governmental and non-governmental agencies, that provide mental health counseling over the phone.

The Tribhuvan University Teaching Hospital (TUTH) suicide hotline (9840021600) and Patan Hospital crisis helpline for suicide prevention (9813476123) operate 24 hours. The Transcultural Psychosocial Organization (16600102005) provides helpline services between Monday to Friday from 9:30 am to 4:30 pm.