In a bid to address growing mental health problems among inmates, the Ministry of Health and Population has started imparting mental health training to health workers serving in various prisons throughout the country.

Providing mental health training to health workers, carrying out mental health screening of inmates, and running regular yoga classes in prisons are among the programmes authorities concerned have planned, officials said.

“We are planning to run regular yoga and meditation classes in prisons,” said Dr Prakash Budathoky, director at Central Jail Hospital. “For that, we have been planning to hire yoga gurus.”

There are around 27,000 inmates in 74 prisons functioning in 72 districts across the country. It is estimated that more than 40 percent of prisoners have various types of mental health problems.

Overcrowding in most of the prisons, lack of privacy, feelings of guilt and injustice from the court, worries for the future, homelessness, and isolation from family members are among the reasons for high mental health problems in the inmates, doctors say.

Health problems among the inmates is a global phenomenon, said Budathoky. “The problems are comparatively more in our country and various factors are responsible.”

Most prisons have been accommodating prisoners more than double their capacity. Experts say overcrowding in the prisons increases tension among the inmates. They struggle for space, logistics, and medical care, which increases the risk of fights, skirmishes, and there is poor cooperation amongst them. This often leads to psychological problems.

Doctors at the Central Jail Hospital said that they have been planning to impart yoga and psycho-social training to some educated inmates, who are going to be staying in prison for years.

According to officials at the Health Ministry, health workers serving at the Central Jail Hospital, Dillibazar Jail, Nakhu Jail, Bhairahawa Jail, and Tulsipur Jail have already received mental health training. They said that health workers serving in at least 25 prisons will get training this year and if the budget allows, more of them will be trained to assess the condition of prisoners.

“We are also planning to organise mental health screening on inmates in prisons,” said Dr Phadindra Prasad Baral, chief of the mental health section at the Epidemiology and Disease Control Division. “Experts in psychiatry, psychology, and other social counselors will carry out the screening and provide treatments.”

Along with mental health issues, the prisoners have also reported other problems, including communicable and non-communicable diseases—sugar, pressure, renal problems, thyroid, respiratory ailments and tuberculosis.

Doctors say many prisoners have been suffering from anxiety and depression. Some have been suffering seriously and are being treated at the Nepal Mental Hospital.

Baral said mental health problems have been emerging as a major public health issue, of late, in the overall population.

“Studies have shown that around 20 percent of the total patients visiting the out-patient department at any hospital have been suffering from mental health problems,” said Baral. “The problem is alarmingly high among the prisoners.”

Panic disorder, agoraphobia, separation anxiety disorder, social phobia, substance use, psychotic disorder, adjustment disorder, dissociative identity disorder, conversion disorder, and epilepsy are the various types of mental health issues among Nepalis, which are also being found among the inmates.

Lately, more people are having mental problems as they struggle to cope with financial, educational, employment, health, and family issues. Stress, anxiety, and trauma exacerbate mental health problems, according to doctors.

A study carried out by the Nepal Health Research Council showed that about 13 percent of the population suffers from some form of mental disorder, which means around one in eight people have mental health issues.

The World Health Organization says that one in four people in the world have been affected by mental or neurological disorders at some point in their lives and around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill health and disability, worldwide.

Nepal has included some medicines for mental health problems in the essential drug list, which are distributed for free at the government health facilities, but its implementation has been rather weak.