Many local units in the Kathmandu Valley say they are unaware of a three-month nationwide mental health awareness campaign launched last week by the Ministry of Health and Population. The lapse has exposed weaknesses in federal-local coordination.

Binod Kumar Shah, a public health official at Tarakeshwar Municipality, said neither he nor his colleagues had received any formal communication about the campaign.

“We neither got a letter nor an email from any agency about the nationwide mental health drive,” said Shah. “We also don’t have a budget to run a three-month campaign. Everyone knows that without money, it is simply not possible.”

The Health Ministry had launched the campaign with much fanfare last Wednesday, to address growing mental health problems, especially among youths.

Officials claimed the campaign was necessary to address the mental health issues that have spiked especially in the aftermath of the Gen Z protests in September.

However, Tarakeshwar Municipality is not alone. Kathmandu Metropolitan City and several other local units in the Kathmandu Valley appear unaware of the federal government’s campaign.

“Last year, we organised a mental health clinic in ward-11’s urban health promotion centre, and we are planning to organise this year also,” said Nali Bajracharya, a health official serving at the Health Department at the city office. “We don’t have any plan to launch an awareness drive across the entire city.”

Health Ministry officials, meanwhile, insist that they formally requested provincial and district health authorities to roll out the campaign in local units.

“We have asked provincial health authorities to launch a three-month-long mental health awareness campaign in local units under their respective jurisdictions,” said Dr Radhika Thapaliya, director at the National Health Education Information and Communication Centre under the Department of Health Services. “We also sent emails to all 753 local units. Officials in some local units may not have opened or checked those messages.”

Officials concede that no additional budget has been allocated for the campaign, and the concept of the campaign is to talk to people which does not require extra cost.

But health officials serving in local governments strongly disagree.

“Without allowances for food and travel, how can we ask people to participate in a campaign,” said Shah of Tarakeshwar Municipality. “Last year we hired counselors and deployed them to schools. The classes were effective, demand for such classes from other schools is high, but we don’t have the budget to expand such classes.”

Health Ministry officials say they will mobilise 1,500 school health nurses who are already on the government payroll, community leaders, religious figures, teachers, health workers, community workers, and female community health volunteers for the campaign, without spending extra.

Officials say that during the campaign, health workers will make people aware about mental health problems, promote healthy coping and stress management practices, and raise awareness about misconceptions and stigma associated with mental health problems.

Health workers serving at the local level say the plan sounds good, but is impossible to run without a budget.

“Forget about the success of the campaign. It is impossible to even start a campaign without budget,” said an official at the Department of Health Services, asking not to be named, as he is not authorised to speak to the media. “Local units even don’t even launch dengue search and destroy campaigns without additional budget.”

Some officials say new campaigns are routinely announced after every change of health minister, often for political credit rather than real results.

Health Ministry officials say the three-month campaign aims to address a growing mental health burden, which it says has spiked after the Gen Z protests.

The youth-led anti-corruption protests on September 8 and 9 caused unprecedented damage to public and private property in Nepal and forced out the KP Sharma Oli-led coalition government. At least seventy-seven people, mostly youths, were killed in police crackdown.

Nepal is among the countries with highest suicide rates.

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.

Likewise, the prevalence of current suicidal thoughts among adolescents was around four percent, while suicidal attempt in the same age group was 0.7 percent. The same report also shows that 0.6 percent of children and adolescents were found to have been suffering from depression.

The prevalence of suicidality, including current suicidal thoughts, lifetime suicidal attempts and future likelihood of suicidal thoughts, was found to be prevalent in 7.2 percent of the population.

Experts say the true scale of mental health problems among children and adolescents could be several times more than what the survey portrays. They say that around 10 to 15 percent of the total children and adolescent population could have been suffering from various types of mental health issues, and due to methodological problems, surveys cannot capture the full extent of the problem.

Multiple studies including one carried out by the Nepal Health Research Council in the past shows that about 13 percent of Nepalis suffer from some form of mental disorder. This means around one in eight Nepalis have mental health issues.

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

Nepal Police data show that 7,055 people died by suicide in fiscal year 2081/082, which is 19 cases a day on average. The data shows that suicide cases have increased by 63 percent in the past one decade—4,332 suicides in the fiscal year 2071/072 and 7,055 cases in the fiscal year 2081/082.

Despite the problems, people generally do not tell about their problems openly due to fear of stigmatisation and isolation from the society, according to experts.