Premram Tiruwa’s two sons suffer from undiagnosed mental illnesses. Twenty-six-year-old Pradip and his 22-year-old brother Ramesh live with their father, Premram, at Dasharathchand Municipality in Baitadi.

“Both my sons have been suffering from some kind of mental disease,” said Premram. “But we haven’t been able to identify the disease.”

Both Pradip and Ramesh developed their symptoms almost a decade ago, but haven’t received a proper diagnosis for lack of a proper medical facility in the district.

“I took them to the district hospital a few years ago for treatment. The hospital referred them to another hospital saying that it did not extend mental treatment services,” said the 60-year-old father. “I did not have the money to take them to a private hospital.”

For years, he has been frequenting the district hospital seeking treatment for his sons, and every time he has been referred to other hospitals.

“I took them to faith healers and opted for homeopathic treatment after the hospital turned us away. But nothing worked,” said Premram.

Most mental health patients in Baitadi and other hill districts of Sudurpaschim Province spend their lives battling mental illnesses, and are never properly diagnosed or treated.

“Mental health patients in Baitadi and other districts in the region are deprived of treatment. The government authorities does not even have the data of the exact number of mental health patients in the district,” said Saraswati Nepali, a Baitadi-based rights activist. She said mental health patients from poor economic backgrounds have to suffer the most since they cannot afford to go outside the district for treatment.

According to Dr Sandip Okheda, chief at Bajhang District Hospital, around 30 to 40 percent of patients visiting the hospital’s OPD show symptoms of mental illness.

“Up to two mental health patients visit the hospital in a week,” said Okheda.

The district hospital refers patients suffering from serious mental health issues to hospitals outside the district since it does not have specialists to treat these cases.

“We purchase the medicines for minor mental health issues ourselves. But patients from poor economic backgrounds cannot afford them and we cannot provide it to them free of cost,” said Okheda.

Until five years ago, Mental Disease Consultation Centre, a non-governmental organisation, was providing mental health services in Bajhang. The organisation had set up a desk at the district hospital.

According to Dhirendra Khadka, an official at the health unit of Thalara Rural Municipality, there are 25 mental health patients in Kotbhairab settlement of the local unit alone, but the authorities do not have supporting data.

“Firstly, mental health patients in the district suffer because their illness remains undiagnosed. Secondly, even if there was proper diagnosis, there is no mechanism for treatment in district hospitals,” said Khadka.

(Basanta Pratap Singh contributed reporting from Bajhang)