Abstract
It has been over a decade since the government of Nepal adopted the National Mental Health Policy (NMHP) in 1997. This article analyses the current provision of fragmented mental health services in Nepal through case scenarios from Jumla in northwest and Janakpur in southeast Nepal, criticises the proposed mental health Act, discusses the reasons why the NMHP has not been implemented and suggests future models of delivering mental health services in the wider community. Absence of a mental health section within the department of health, insufficient budget, chronic shortage of trained manpower, and unplanned growth of private medical institutions appear to be the issues deserving urgent attention. Setting up specialist psychiatric facilities in all developmental regions or future states, developing community mental health programmes and integration of mental health into general health care are the ways forward to meet the needs and expectations of the new federal Nepal.
Highlights
Nepal may be moving forward politically, but it is going backwards in its delivery of mental health care
The mushrooming of private medical colleges may give an illusion that each of them has a dedicated department to provide psychiatric training to their medical students, but the reality is different
There are no community mental health services (CMHS) apart from some basic training programme run by a voluntary organisation in seven out of 75 districts of Nepal
Summary
Nepal may be moving forward politically, but it is going backwards in its delivery of mental health care. At a recent mental health camp in Janakpur, it was dismayed by the absence of any psychiatric service for a population of over a million people. This case highlights several problems regarding mental health service provision in Nepal at the moment.
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