In a bid to address the ongoing shortage of psychiatric doctors at many health facilities across the country, the Ministry of Health and Population has started imparting mental health screening and treatment training to paramedics serving at district and peripheral health facilities.

Officials hope that the training will help in addressing the growing burden of mental health problems in the country.

“We have imparted mental health screening and treatment training to 28 paramedics serving in Dolakha district,” said Dr Phadindra Prasad Baral, chief of the mental health section at the Epidemiology and Disease Control Division. “Those who took part in the five-day training will carry out screening of mental health problems, including bipolar disorder, depression, anxiety, psychosis, alcohol dependency, and schizophrenia, among others; prescribe medicines of certain doses; and refer the patients to consultant doctors.”

Of late, mental health problems have emerged as a major public health issue in Nepal. Studies show that around 20 percent of the total patients visiting the outpatient 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. This means around one in eight Nepalis have mental health issues.

Likewise, a report of the National Mental Health Survey Nepal-2020 shows that the prevalence of mental disorders among adolescents was 5.2 percent that year, and the neurotic and stress-related disorders were the most prevalent at 2.8 percent.

Nepal is also among the countries with the highest suicide rates. The country witnessed an alarming rise in suicide cases in the last fiscal year. According to data provided by the Nepal Police, as many as 7,223 people killed themselves in the fiscal year 2023-024, which is the highest ever recorded in a year.

As people struggle to manage even the most basic of needs, including food, housing, health care, and job security, among others, an increasing number of them are facing mental stress, experts say.

Studies show that the magnitude of suffering, the burden and costs for individuals, families and societies arising from mental health disorders are alarming in Nepal.

Moreover, the country simply does not have enough experts to treat and cure mental health problems, they say. The prospect of hiring mental health experts for district hospitals in the near future is slim, as the whole country has a shortage of such experts, officials say.

They informed that less than two dozen psychiatric doctors work in state-run health facilities, and most work in urban centres such as Kathmandu Valley, Pokhara, Chitwan and Nepalgunj. Some mental health experts work in private health facilities, but their presence is limited to big cities.

“Mental health training to paramedics and other health workers has helped in identifying problems in the initial stage, providing timely treatment, and ensuring access to treatment to those residing in remote villages,” said Dr Ananta Prasad Adhikari, a mental health expert. “This programme has also raised awareness about mental health problems, from which anyone can suffer, and lessen the case load in central hospitals.”

Officials at the Health Ministry said that federal and provincial government agencies and non-governmental organisations will impart training to around 500 paramedics in the current fiscal year. Those paramedics will also be connected to a WhatsApp group of mental health experts from whom they can seek expert help.

Officials said that the use of WhatsApp and Viber groups has helped health workers communicate with experts, understand problems, and prescribe proper medications.

Nepal has placed 11 types of psychotic medicines for mental health conditions on the essential drug list, which are distributed for free at government health facilities.

The World Health Organisation says one in four people globally gets affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill health and disability worldwide.