Mental Health Services in Nepal
History of mental health services in Nepal is not long.
Mental health services in Nepal
remained unknown till 1961 AD. First psychiatric OPD services were started in 1961
in Bir hospital, Kathmandu.A five-bedded in patients in the same hospital in
1965, which was further extended to 12 beds in 1971. In 1972, a 10 bedded Nero
psychiatric unit was established in the a Royal Army Hospital was separated,
which was then shifted into the Lagankhel, Patan and it has got 50 beds at
present.
T.U. Teaching hospital was established in Maharajgunj,
Kathmandu in 1983 where psychiatric OPD services started in February 1986. It
was followed by addition of 12-bedded psychiatric patient units in December
1987.During 1983-84 a number of non-government organization were started. Nepal's own
community mental health service came into existence following Shresth et al,
(1983) report. Following this survey, training was arranged for health
assistants and paramedical in mental health in around Bhaktapur. This led to
setting up of satellite mental health clinic in Bhaktapur.
United Mission
to Nepal (UMN) community mental health program was started in 1984 and stated a
district program in Lalitpur. In 1989, the Department of Psychiatry of TU
Teaching Hospital stared the Mental Health Project by launching community
mental health program in seven districts of Nepal. There was no training
facility for psychiatrists, clinical psychologists and psychiatric nurses in Nepal, before
1997. In the 1997 April, there full time residential MD psychiatry training
program was started in the Department of Psychiatry, TU Teaching Hospital,
Institute of Medicine, Kathmandu. In 1998 April, two years M. Phil in clinical
psychology course was started in TUTH, Institute of Medicine. The Diploma
Nursing Program was started in Nursing Campus, Maharajgunj, and Institute of Medicine. MD Psychiatry training program
was also started in BPKIHS, DHARAN.
Now many private Medical Colleges are also providing
psychiatric services in different parts of the country. Chitwan medical collage
which is one of them, located centre part of the country providing good
psychiatric services from starting time and also has lunched diploma
psychiatric nursing programme. It also has 25 beded in door services. Many
private hospitals also are available for treatment of mentally ill people.
Though there are no psychiatric social workers in Nepal, efforts are being made to
start the psychiatric social worker training in the country. In Nepal mental
health policy was formulated and adopted by his Majesty's government of Nepal in 1996.
The components of minimum mental health policy include:
1.
To ensure the
availability and accessibility of minimum mental health service for all the
population of Nepal.
2.
To prepare
human resources in the area of mental health.
3.
To protect the
fundamental human rights of the mentally ill.
4.
To improve
awareness about the mental health.
There is an essential
drug lists for different level of health institution. There is no separate
mental health legislature yet in the country. However, final draft of mental
health legislation has been prepared in the Ministry of health and population
for review and finalization. Less the n 10% of all health expenditures are directed
towards mental health (0.17%), (WHO-SIMS 2007). All the expenditures spend as
mental health, huge amount of them are directed towards mental hospital, where
annual budget was 10 million rupees in 2005.At present there are 18 outpatients
mental health facility are available in the country. (WHO-AIMS, 2007). There is
no separate mental health facility for children and adolescent. Similarly,
there are 17 community based psychiatric inpatients units available in the
country. There is one mental hospital available in the country. In Nepal, the
total numbers of human resources working in mental health facility, including
private sectors are as follows: Forty two psychiatrists, 60 clinical
psychologists, no social workers, no occupational therapists, and 25 other
mental health workers (WHO AIMS 2007)
The weaknesses of
mental health system in Nepal
are:
· Financial constraints
· Only one Mental Hospital
· Mental health services are not easily available
· Stigma around mental health
· Poor infrastructure
· Limited number of human resources
· No mental health legislation
· Poor mental health information system
· No separate division for mental health under the
ministry of health
· No developed community mental health services
· No facility for rehabilitation of chronic mentally
ill people
Strengths of the
mental health system in Nepal
are:
· Country has national mental health policy
· Good network within the general mental health can
be integrated
· General increase in awareness of mental health in
general population
· Increasing number of people seeking treatment in
the mental health institution
· Available of
psychotropic medicines
· Private medical college and NGOs are providing
psychiatric services.
· Good family
system, which takes responsibility to their sick family member at home.
· Member of world psychiatric association (WPO).
National Mental Health Policy of Nepal
1. To ensure the availability and
accessibility of minimum mental health service for all the populations of Nepal
by the end the Tenth National Five Year Plan, in particular for the most
vulnerable and under-privileged group of the population, by integration mental
health service into the general health service system of the country, and
adopting other appropriate measure suitable to the community and the people.
2. To prepare Human resources in the area of mental
Health in order to provide for the above motional Mental Health Service. This
will include
Mental Health training of all
health worker, preparation of specialist Mental Health manpower, and training
of group as per need
3. To protect the fundamental human right of the mentally ill people of Nepal
4. To improve awareness about
mental health, mental disorders, and the promotion of mentally healthy
lifestyle, in the community by participation of community structures, and
amongst health workers.
Plan of Action of the National Mental Health Policy
As expressed earlier the main goal of this,
policy is to provide at least a minimum amount of mental health care in
Nepalese citizens. For this, the arteries adopted are the decentralization of
the services, the integration of mental health with general health services and
the enhancing of community participation. To perform these, a set of activities
in planned. The main concerns of the implementing agency, the Ministry of Health,
should be considered- that is, availability of resources, manpower, materials
and finance and a logistical system to implement these.
The national mental health policy should be seen as part
of the total socio-economic development of the country, and very much as an
essential component of the national health policy. The activities recommended
here are therefore board outlines of activates in line with the National Health
Policy of the Ministry of Health. As on other areas of health care, the
approach will be multi-sectoral, with liaison, cooperation and involvement of
other concerned government, ministries and departments as required. e.g.
Ministry of education, Ministry of Social Welfare, Ministry of finance an
National Planning Commission etc.
Dr C P Sedain,Psychiatrist,
Chitwan Medical
College
Hi, there. I am Tom Neil and I want to describe how life had been for my younger brother living with schizophrenia and how he had been permanently able to defeat this debilitating disease via a naturopathic, herbal method.
ReplyDeleteMaicon - my kid brother was twenty years old when he was brought to the emergency room by the campus police of the college from which he had been suspended several months ago. A professor had called and reported that he had walked into his classroom, accused him of taking his tuition money, and refused to leave.
Although he had much academic success as a teenager, his behavior had become increasingly odd during the past year. He quit seeing his friends and no longer seemed to care about his appearance or social pursuits. He began wearing the same clothes each day and seldom bathed. He lived with several family members but rarely spoke to any of them. When he did talk to them, he said he had found clues that his college was just a front for an organized crime operation. He had been suspended from college because of missing many classes. My sister said that she had often seen him mumbling quietly to himself and at times he seemed to be talking to people who were not there. He would emerge from my room and ask my family to be quiet even when they were not making any noise.
My father and sister told the staff that Maicon's great-grandmother had had a serious illness and had lived for 30 years in a state hospital, which they believed was a mental hospital. Our mother left the family when Maicon was very young. She has been out of touch with us, and they thought she might have been treated for mental health problems.
Maicon agreed to sign himself into the psychiatric unit for treatment. The whole family except I had agreed to have Maicon transferred to a mental asylum. I knew inwardly there was still some plausible means by which my kid brother could overcome this condition. I knew botanical means of treatment will be more favorable than any other type of treatment, and as such, I had taken a keen interest in the research of naturopathic alternative measures suitable for the treatment of schizophrenia. I had pleaded for some little patience from the family in the delay of the transfer, I was looking forward to proving a point to the entire family, of a positive botanical remedy for this condition.
It was during my ceaseless search on the internet I had been fortunate enough to come across Dr. Utu Herbal Cure: an African herbalist and witch doctor whose professional works had majored on the eradication of certain viral conditions, especially schizophrenia, ( improving the memory capacity positively), via a traditional, naturopathic process and distinguished diet plan. It was by the administration of this herbal specialist that my brother had been able to improve his condition for better.
Before the naturopathic remedy - Maicon's story had reflected a common case, in which a high-functioning young adult goes through a major decline in day-to-day skills. Although family and friends may feel this is a loss of the person they knew, the illness can be treated and a good outcome is possible.
My brother Maicon is just like many other patients out there suffering from this disease. Although he was able to overcome this condition via a naturopathic herbal remedy administered by this African herbal physician and saved completely thus, rekindling the lost joy which had been experienced by the family members.
I wish to use this opportunity to reach across to anyone who may happen to be diagnosed with this disastrous condition to spread the hope of an everlasting herbal remedy that is capable of imposing a permanent end to this disease.
For more information concerning this naturopathic herbal remedy, feel free to contact this African herbal practitioner via email:
drutuherbalcure@gmail.com