Pradip Parajuli

Mental health has long been an overlooked issue in Nepal’s healthcare system, but in recent years, the government has made efforts to integrate mental health services into the national health agenda. This blog explores Nepal’s mental health policy, its evolution, current initiatives, and the challenges that remain in implementing effective mental health care nationwide.

The Evolution of Nepal’s Mental Health Policy

National Mental Health Policy, 1996 (2052 BS)

Nepal adopted its first National Mental Health Policy in 1996, aiming to integrate mental health services into primary health care. The policy had four main objectives:

1. Availability and Accessibility – Expanding basic mental health services to all citizens by integrating them into primary healthcare.
2. Human Resource Development – Training healthcare workers in mental health treatment and care.
3. Protection of Human Rights – Ensuring the dignity and rights of individuals with mental health conditions.
4. Public Awareness and Stigma Reduction – Promoting awareness and reducing societal stigma around mental illness.

Despite these well-intended goals, implementation was weak due to a lack of resources and prioritization. Moreover, a proposed Mental Health Act was never enacted (Upadhaya & Jha, 2021).

Draft National Mental Health Policy, 2017 (2073 BS)

Recognizing the need for a more updated framework, Nepal’s Ministry of Health and Population drafted a new National Mental Health Policy in 2017. This policy aimed to:

• Ensure quality mental health services are accessible to all.
• Develop skilled human resources for mental health services.
• Protect the fundamental rights of people with mental illnesses.
• Promote mental health awareness and reduce stigma.
• Strengthen mental health research and information systems (Luitel et al., 2020).

Unfortunately, this draft policy was not approved by the government, delaying much-needed reforms.

Current Initiatives and Strategies

Community Mental Health Care Package, 2017 (2074 BS)

To bridge the gap in mental health services, the Ministry of Health and Population introduced the Community Mental Health Care Package in 2017. This program integrates mental health services into primary healthcare facilities using the WHO’s Mental Health Gap Action Programme (mhGAP). It includes training for non-specialist healthcare providers to enhance service delivery at the community level (Jha et al., 2021).

National Mental Health Strategy and Action Plan, 2020 (2077 BS)

In 2020, Nepal introduced the National Mental Health Strategy and Action Plan, focusing on:

• Expanding access to mental health services across Nepal.
• Integrating mental health care into primary health services.
• Promoting collaboration between government and non-government sectors.
• Ensuring a rights-based and participatory approach to mental health services.
• Enhancing research and data collection for evidence-based policymaking (Maharjan et al., 2022).

Challenges in Implementation

Despite these policies and initiatives, several barriers prevent effective mental healthcare implementation in Nepal:

1. Limited Resources – The government allocates minimal funding to mental health compared to other healthcare priorities.
2. Workforce Shortages – There is a severe shortage of trained mental health professionals, especially in rural areas.
3. Social Stigma – Cultural stigma prevents many individuals from seeking help.
4. Weak Policy Implementation – Delays in policy approval and lack of legal frameworks hinder progress.

The Way Forward

To ensure better mental health care in Nepal, the government must:

• Allocate increased budgetary resources for mental health services.
• Implement community-based mental health programs across all provinces.
• Expand training for healthcare providers at the local level.
• Strengthen policies by approving and enforcing updated mental health laws.
• Promote nationwide mental health awareness campaigns to reduce stigma.

Conclusion

While Nepal has made significant strides in mental health policy, challenges remain in its effective implementation. A stronger commitment from the government, along with collaborative efforts from various stakeholders, can help make mental health services accessible and effective for all Nepalese citizens.

References

• Jha, A. K., Luitel, N. P., & Kohrt, B. A. (2021). Integrating mental health into primary care in Nepal: The role of community mental health programs. BJPsych International, 18(4), 78-81. https://doi.org/10.1192/bji.2021.4

• Luitel, N. P., Jordans, M. J. D., Adhikari, A., & Upadhaya, N. (2020). Barriers and facilitators to mental health policy implementation in Nepal. International Journal of Mental Health Systems, 14(1), 23. https://doi.org/10.1186/s13033-020-00367-5

• Maharjan, S., Pant, P., & Shrestha, S. (2022). Nepal’s National Mental Health Strategy: Achievements and future directions. Asian Journal of Psychiatry, 60, 102683. https://doi.org/10.1016/j.ajp.2022.102683

• Upadhaya, N., & Jha, A. (2021). Mental health law in Nepal: Challenges and opportunities. BJPsych International, 18(3), 56-60. https://doi.org/10.1192/bji.2021.3