Mental health specialists have said the coronavirus pandemic has discontinued the care and treatment of many patients, as the country has been under a lockdown and other restrictions since March 24.

Patients living in small towns and villages have been particularly hit hard, because for many of them their regular therapy sessions and medicines have stopped with the restrictions put in place to control the virus spread.

Doctors at Nepal Mental Hospital in Lalitpur say unlike the patients of other diseases, people suffering from mental illness cannot buy medicines from pharmacies without prescriptions.

Discontinuation of medication or counselling could cause a patient’s condition to deteriorate, say the doctors.

While some hospitals have been offering remote counselling to the patients in these times of pandemic, not every patient has access to phones and the internet to avail the service. 

“I recently offered remote counselling to a Nepali man based in Portugal. He was a former patient who had been suffering from anxiety and depression,” Dr Ananta Prasad Adhikari, consultant psychiatrist at the hospital, said. “It was easy for him to get in touch with me because he lives in Europe. But here in Nepal, there are thousands of people suffering from various mental disorders who do not have internet at their homes to contact the doctors.”

Doctors say discontinuation of psychiatric medication could lead patients to a psychotic, manic or severely depressed state. There is also the risk of patients taking their own lives. 

On Monday, the Nepal Mental Hospital received a patient, a woman in her early thirties from Sindhupalchok district, with severe depression disorder. Her family had been unable to get medical help for her due to the continuous restriction in the movement of public transportation for months on end.

“She had tried to take her own life three times in the last five monts,” Dr Basudev Karki at the hospital, told the Post. “We have prescribed her some medicines and advised her to stay with her relatives in Kathmandu so she could get help whenever she needs it.” 

The data of the Non-communicable Disease and Mental Health Section of the Epidemiology and Disease Control Division show that 6,261 people took their own lives in the fiscal year 2019-20, which is at least 17 people daily. The number was 5,734 or 16 people per day in the fiscal year 2018-19.

“Over 80 percent of the sucide cases are associated with depression,” Karki, the consultant psychiatric at the Nepal Mental Hospital, said. “If the patients taking psychotic medicines discontinued, it could lead to depression and suicide in
extreme case.”

According to the Non-communicable Disease and Mental Health Section of the Epidemiology and Disease Control Division, the coronavirus pandemic has had a severe impact on the patients suffering from mental health disorders as they are confined in their homes, unable to reach health facilities and get their medicines.

“We have received numerous complaints from doctors and hospitals regarding discontinuation of medicine regimes and counselling as a result of the pandemic,” Dr Phanindra Prasad Baral, section chief of the NCD and Mental Health Section of the division, said. “Cases of mental health problems have been increased due to the pandemic. To help the patients, we have directed the health facilities to provide medicines for a month as well as deployed over 150 counselors in various districts.”