The Ministry of Health and Population in Nepal is launching an innovative initiative to identify individuals suffering from mental health problems by harnessing the services of female community health volunteers (FCHVs). This effort involves the organization of an orientation training program focused on mental health for FCHVs serving across the nation.
The primary objective of this initiative is to ensure that thousands of individuals grappling with mental health issues, who have thus far lacked access to essential treatment, can now receive timely and much-needed care, thanks to the invaluable assistance of FCHVs.
Dr. Phanindra Baral, Chief of the Mental Health Section at the Epidemiology and Disease Control Division, shared insights into this endeavor, stating, “We have been preparing to organize a two-day mental health orientation for FCHVs. With the support of female community health volunteers, we aspire to identify a substantial number of mental health patients, primarily residing in remote areas, facilitating their prompt access to treatment.”
Nepal boasts a formidable force of 51,423 female community health volunteers. Officials emphasize the pivotal role played by FCHVs in the successful execution of various public health programs in the country, encompassing initiatives such as Vitamin A supplements, deworming campaigns, maternal and child health, nutrition, immunization, and efforts to combat vector- and water-borne diseases.
Nepal has made remarkable progress in reducing its maternal mortality rate, plummeting from 539 in 1996 to 239 in 2016, earning recognition through the Millennium Development Goal award. Much of this achievement is attributed to the diligent efforts of FCHVs.
In addition to their contributions to public health, these health volunteers and mother’s groups have also played a pivotal role in women’s empowerment and the mitigation of violence against women. Dr. Baral revealed ongoing mental health training for health workers across 55 districts and highlighted that the orientation program for FCHVs would commence once the training for health workers concludes.
To facilitate this vital mental health initiative, Nepal’s Health Ministry has allocated one million Nepalese Rupees to each of the 55 districts. Dr. Basudev Karki, a consultant psychiatrist at the Nepal Mental Hospital, detailed the approach, stating, “We will provide case studies for the identification of mental health problems—such as anxiety, depression, alcohol use, psychosis, and suicidal thoughts—to FCHVs. FCHVs will encourage patients to seek treatment at nearby health facilities and support them in adhering to their prescribed medications.”
Research underscores the magnitude of suffering, societal burdens, and financial costs associated with mental health disorders in Nepal. The country contends with one of the highest suicide rates globally, emblematic of severe mental health challenges.
Data from the Nepal Police reveals that during the fiscal year 2022-2023, a staggering 6,993 individuals died by suicide, equating to over 19 daily suicides on average. Alarming, too, is the fact that 56 percent of these suicide victims are men.
Nepal faces challenges in addressing mental health issues due to deeply rooted social stigma, limited awareness, and a reluctance among the population to discuss such concerns openly. Experts note that suicide is seldom the result of a single cause but arises from complex circumstances compounded by various factors.
Increasing numbers of Nepalis grapple with mental health problems, exacerbated by rising living costs and the challenges associated with meeting fundamental needs such as food, shelter, healthcare, and job security.
The ripple effects of suicides and suicide attempts reverberate throughout families, communities, and societies, amplifying the urgency of addressing mental health issues. A previous study by the Nepal Health Research Council indicated that approximately 13 percent of Nepali citizens experience some form of mental disorder, highlighting a significant mental health burden. Unfortunately, Nepal suffers from an acute shortage of mental health professionals, making it challenging to provide adequate treatment and care.
Health Ministry officials acknowledge the slim likelihood of recruiting mental health experts for district hospitals in the foreseeable future, primarily due to the scarcity of such professionals. Estimates indicate that there are approximately 200 psychiatric doctors in the country, with the majority concentrated in major cities.
