Nepal Reports Average of 20 Suicides Daily Amidst Rising Mental Health Concerns

Kathmandu. According to the Non-Communicable Diseases and Mental Health Branch of the Epidemiology and Disease Control Division (EDCD) under the Department of Health Services, an average of 20 people commit suicide daily in Nepal. According to the branch, seven thousand citizens have committed suicide by the third week of Asar in the fiscal year 2082/83.

Suicide incidents are increasing in Nepal due to deteriorating mental health.

Psychiatrists say that this problem can be eliminated if initial symptoms like excessive stress are identified in time and treatment and counseling are provided without hesitation. Along with mental health, debt, poverty, family conflict, political frustration, and social, economic, political, and biological factors are increasing the suicide rate.

According to psychiatrists and psychologists, people choose suicide due to impulses arising in the immediate situation. They say that such thoughts can be rescued by providing empathy and social support.

Stakeholders have suggested that timely treatment of mental illness is necessary to raise awareness about mental health to reduce and prevent the suicide rate.

Psychosocial Support is Essential

Senior psychiatrist Dr. Ananta Adhikari says that psychosocial support is needed for individuals with mental health problems. "Mental health problems or impulses are hidden behind suicides; to stop this, mental health awareness must first be raised, and identified mental health problems must be addressed in time," Adhikari says. "Psychosocial support is extremely essential for individuals who share signs of such thoughts or talk about despair."

He said that society should respect those who have attempted suicide and stop treating them with contempt or stigmatizing them. "Social harmony must be maintained. This is an all-encompassing issue. No single party can stop it alone," he said.

Similarly, Dr. Pomawati Thapa, head of the Non-Communicable Diseases and Mental Health Branch of the division, said that the Ministry of Health and Population has started a rapid response considering the increasing incidents in society recently. She also informed that the Suicide Risk Assessment and Management Directive, 2083 has been issued at the Health Minister level.

She said, "This directive, which is in the implementation phase, clearly outlines the roles to be played by all three tiers of government, civil society, local leaders, and health workers in suicide prevention."

Thapa's Statement Verbatim

Legal provisions, strategies, policies, and directives related to mental health have been formulated, and technical coordination with local and provincial governments is ongoing. Mental health services have not yet reached all parts of the country due to geographical and technical reasons. Accepting this reality, the government has expanded the capacity building program for health workers. The necessary criteria for operating separate rooms for mental health counseling in hospitals have already been prepared.

Currently, these counseling rooms have been operational in various levels of hospitals, while implementation is underway in others. Similarly, various awareness activities are being conducted at the community level to promote and prevent mental health. Activities are being carried out focusing on the National Mental Health Strategy and Action Plan, 2077 to systematize the mental health sector.

What is the Government Doing for Prevention?

Following recent suicide incidents, the Ministry of Health has stated that it has started working by focusing on three main strategies. Under the first phase, special videos and awareness materials are being widely disseminated through social media and communication channels to spread awareness among the public.

The second strategy addresses the risk of sensationalizing suicide incidents in the media, which can lead to imitation by individuals with weak mentalities and an increase in patient load in health institutions.

To this end, the ministry has fully activated Tele-Mental Health, Telemedicine, and Hotline services. Similarly, the Department of Health Services has stated that special instructions have been issued at the secretary level for health institutions across the country to be on high alert and ready to provide services at any time.

The department has stated that the government is emphasizing multi-sectoral and inter-ministerial coordination to address other economic-social aspects while strengthening the mental health sector to solve this complex problem.

Psychologist Padmaraj Joshi said that understanding the reality of suicide and increasing mental health literacy is essential for its reduction. Joshi said, "90 percent of total suicide incidents are due to mental illness, and the remaining 10 percent are due to sudden impulses." According to him, most individuals who plan suicide have been suffering from severe anxiety or mental problems for at least two years, while in some cases, immediate causes like exam results exist.

90 percent of people in the final stage of depression are plagued by the thought "this life is meaningless" and choose the path of suicide upon receiving a small excuse or stimulus, according to Joshi. "Therefore, understanding the biological and psychosocial factors seriously and identifying the signs and symptoms shown by individuals in time is the first step in prevention," Joshi said.

Connecting the suicides of Prem Narayan Acharya and Ganesh Nepali, psychologist Joshi expressed sadness that people were busy making videos instead of engaging in rescue efforts. He analyzed that if that sensitive minute of impulse could have been overcome, or if someone had intervened in time, his life could have been saved, and it would take at least 6 months for such thoughts to return.

It has become essential to raise mental health literacy among ordinary citizens, security personnel, and public officials to prevent such incidents from recurring. "By teaching state bodies how to identify signs of suicide and how to rescue in times of crisis, major accidents can be easily prevented with timely small awareness and support," Joshi says.

Government Disobeying Court Verdict

Although the Supreme Court ordered the establishment of a Mental Health Division under the government mechanism to prevent incidents including suicide, the government has neglected to implement this decision. The Supreme Court had ordered the establishment of separate Mental Health Divisions and branches to make related work effective.

Although there is a Mental Health Branch under EDCD, this branch is linked to non-communicable diseases. The Supreme Court's order to create and appoint positions for psychiatrists, psychologists, and trained counselors in hospitals and local levels has not been implemented.

According to the full verdict of the Supreme Court on Jestha 12, 2082, it was ordered to revise the National Mental Health Policy, 2053 and issue a new Mental Health Policy, incorporating sufficient strategies to implement the right to mental health inherent in the right to health guaranteed by the Constitution of Nepal.

However, a new Mental Health Policy has not yet been issued. Organizations active in suicide prevention say that this order, which directed the Supreme Court to create an environment where individuals suffering from mental health problems can receive necessary medication and treatment by arranging structures, budgets, and human resources of equal standard in the field of mental health as in physical health, has also not been implemented.