Health workers serving in prisons across the country will be given mental health screening training, as the Ministry of Health and Population has decided to allocate a budget to continue training health workers to address the growing mental health problems among inmates.

Compared to the general population, inmates serving jail terms are much more vulnerable to mental health problems, officials said.

“We have decided to set aside a budget for mental health screening training to health workers serving in prisons,” said Dr Pomati Thapa, chief of the Mental Health Section at the Epidemiology and Disease Control Division. “We hope that mental health screening training for health workers would help address ongoing mental health problems in inmates.”

The Health Ministry had imparted such training to health workers in some districts but the programme was discontinued. Along with the screening training to health workers, the ministry had also planned to run regular yoga and meditation classes in prisons, but that, too, could not continue, officials say.

There are around 27,000 inmates in 74 prisons in 72 districts across the country. It is estimated that more than 35 percent of prisoners have various types of mental health problems. Health Ministry officials, however, claim only 15 percent of the ailing inmates suffer from mental health problems.

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

Moreover, 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 among them. This often leads to psychological problems.

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

Doctors say many prisoners suffer from anxiety and depression. Those with serious problems are being treated at the Patan Mental Hospital.

“Health problems including mental health issues and other non-communicable diseases among inmates is high in our country,” said Dr Prakash Budathoki, spokesperson at the Health Ministry. “Several measures have been taken to address health issues of the inmates, and the planned mental health screening training is among them.”

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

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

Studies show that around 20 percent of the total patients visiting the out-patient department at any hospital suffer from mental health problems.

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 one in four people in the world are 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.