In 2020, the National Mental Health Survey Nepal reported that 5.2 percent of adolescents suffered from mental disorders, with neurotic and stress-related conditions accounting for 2.8 percent. The prevalence of suicidal thoughts among adolescents was approximately 4 percent, while suicide attempts stood at 0.7 percent.

Three years later, according to data from Nepal Police, 7,223 people died by suicide in the fiscal year 2023-24, following a total of 13,823 suicides in the previous two years (2021-22 and 2022-23).

More than 40 percent of these victims were farmers, with students representing the second-largest group at 15.4 percent.

Mental health professionals see a major shift in youths’ mental health, particularly in terms of awareness and the growing inclination to seek treatment.

Dr Rishav Koirala, a psychiatrist, researcher, and executive director of the Brain and Neuroscience Center, notes that the past decade has seen a generational transformation in attitudes toward mental health.

Youths of today, aged 23–30, were teenagers when discussions about mental health began gaining traction online. The coronavirus pandemic, which triggered lockdowns starting in March, 2020, and the ensuing economic hardships are believed to have made the issue of mental health more acute.

Celebrities from Hollywood and Bollywood also provided an impetus to the debate, openly discussing mental health issues from depression to bipolar disorder, experts say.

A decade before, there was a tendency to suppress problems and view them as trivial, says Koirala. Today’s youth, however, believe in prevention and are more likely to seek professional help.

He recalls instances where young people demanded consultations to address their struggles, even when the issues were minor. “Some have mental disorders, but others don’t. Regardless, it’s encouraging to see this proactive attitude,” Koirala says.

Ruban Dahal, a counsellor with 12 years of experience at Mankaa Kura, seconded that. “Many youths who are about to go abroad come with the conviction that they want to be healthy before leaving. It’s a major shift from a decade ago,” he says.

However, Dahal adds that the severity of problems youths face has increased. “The issues of loneliness, isolation, and anxiety have always existed, but their intensity has grown”.

He attributes these issues to challenges like the competition for jobs, career pressures, economic uncertainty, and the growing trend of Nepalis going abroad for study and livelihoods.

As individuals are increasingly adopting social media to connect, communicate and keep up to date with events and issues, youths have fewer in-person social interactions, Dahal explains.

This increased screen time, coupled with platforms like Instagram, creates a culture of showing off achievements, which has fuelled unhealthy competition. Isolation and loneliness, paradoxically created by a heavy dependence on social platforms, are among the most common problems youths face, as per Dahal.

Another trend Dr Koirala has observed is the increasing recognition of adult ADHD (Attention Deficit Hyperactivity Disorder) and personality disorders in youths.

For most of its 200-year history, ADHD was considered a childhood disorder. Only in the 1990s did we start recognising its impact on adults.

“Now, with more research and awareness in the last three to four years in Nepal, we know that adult ADHD is widespread,” says Koirala, who has been handling an average of 20 ADHD-related cases each month.

“Youths are not only exploring symptoms of disorders like borderline personality disorder but also sharing their experiences through blogs and articles,” Koirala says, recounting how a patient he treated wrote an article about their journey and provided resources for others. “This level of openness and awareness was unthinkable a decade ago.”

Even Dahal has seen a rising trend of youths approaching mental support after watching videos and reels on social media.

While social media has amplified both awareness and help-seeking tendencies, it does not come without cons.

Many patients come to Dahal saying they Googled their symptoms or used AI tools like ChatGPT, which showed worst-case scenarios. This often worsens their anxiety and, in cases of OCD, exacerbates their symptoms.

An article by the Post in October 2024 also explored how mobile screens and technology are reducing family interactions.

Psychologist Bina Shrestha from ‘Mankaa Kura’ noted, “With work tied to gadgets, parents struggle to separate work from home, leading to a lack of emotional connection for children.”

“Many youths tell us, ‘There’s no one to understand me or talk to about my problems,’ which shows how isolation has deepened in recent years”, adds Dahal.

Relationship issues are another major concern that youth come with, says Dahal. Live-in relationships, online connections, and cycles of breakups and reconciliations are common, leading to greater frustration and uncertainty among youths.

This shift is reflected in a study by ChildSafeNet and the Sexual Violence Research Initiative (SVRI), which surveyed 4,501 participants aged 16 to 24. The report found that one in four young people in relationships had experienced online intimate partner violence (IPV).

Experts also say language patterns among youths are shifting, with mental health terms being increasingly used as casual terms. This trend diminishes the seriousness of these issues and encourages harmful self-labelling.

Research supports his observation, revealing a rise in casual misuse of mental health terms, with anxiety (48 percent) and depression (37 percent) being the most self-diagnosed.

While there have been some negative trends among youths, positive sides remain too.

Experts say youths understand that treatment isn’t just about medication but also includes lifestyle changes and psychotherapy.

“Misconceptions, such as needing lifelong medication, are diminishing, and there is greater acceptance among youths regarding various treatment methods and approaches. Many even encourage their parents and friends to consider treatment,” says Koirala.

While youths in urban areas like Kathmandu benefit from greater awareness and resources, those in other areas face persistent stigma and limited access to care.

“Many youths outside of areas like Kathmandu seek help only when their conditions have severely worsened,” says Dahal.

He advocates for integrating mental health services into local healthcare systems and incorporating mental health education into school curricula.

There has been a rise of teleconsultation and online mental health platforms among youths, which align with global practices.

However, Koirala warns of a lack of regulation in Nepal regarding who qualifies as a counselor or therapist. “Many unqualified individuals run counselling platforms and wellness centres, which can mislead youths seeking help online”.

The government needs to enforce licensing and qualifications for mental health professionals to protect patients, he suggests.

Beyond leveraging technology, experts stress the need for offline interventions such as community health camps and sensitisation programmes.

They also urge caution on how future generations like Gen Beta interact with technology, given its influence on relationships and self-perception.