Mental Health Challenges Persist in Madhesh Province Amidst Lack of Awareness and Specialists

Janakpurdham. Due to a lack of awareness about mental health, many consider it a normal issue except in severe cases. As a result, its impact is increasing.

Furthermore, in the impoverished settlements of Madhesh, a lack of awareness about mental health means that timely treatment is out of the question, and the inability to recognize it as an illness is leading to serious consequences in society.

On the other hand, there is also a shortage of mental health specialist doctors in Madhesh Province. This poses a challenge in treating mentally ill patients.

According to Sarojchandra Neupane, Director of the Madhesh Province Health Directorate, the province has a population of approximately 6.4 million, but there are only about 10 mental health specialist doctors (psychiatrists) for such a large population.

According to him, medicines necessary for the treatment of mental illness have been purchased and supplied to health institutions. Additionally, under the Saami program, psychosocial counseling services have been expanded to 93 local levels out of 136 local levels. He informed that a 6-month training program is also underway to fill the shortage of counselors.

According to him, despite efforts to expand services, the lack of skilled manpower remains the main challenge.

According to data from the Madhesh Province Health Directorate, suicide incidents have increased in recent years. Experts say that mental health is becoming challenging due to economic, social, familial, educational, and psychological pressures, as well as a lack of timely treatment.

Suicide Statistics in Madhesh
2077/078- 959 people
2078/079- 1,018 people
2079/080- 1,134 people
2080/081- 1,288 people
2081/082- 1,261 people

Increasing Mental Health Problems from Adolescents to Adults
According to the National Mental Health Survey, Nepal-2077, 5.2 percent of adolescents aged 13 to 17 years have some form of mental health problem. Data shows that mental illness accounts for about 18 percent of the total burden of non-communicable diseases in Nepal.

According to Dr. Tejnarayan Mahato, a psychiatrist at Provincial Hospital Janakpurdham, 30 to 35 patients with mental health issues come to the hospital for treatment daily. According to him, in recent years, the number of patients coming with mental problems due to anxiety, depression, insomnia, excessive stress, and the effects of drug abuse has increased.

According to psychological counselor Yugal Kishore Yadav, the number of people seeking mental health counseling has increased significantly in recent years. He said that more people, from adolescents to adults, are seeking counseling due to mental stress, anxiety, lack of self-confidence, family disputes, and pressure from studies and employment.

However, Yadav states that most people hide their problems for a long time and only seek treatment when the condition becomes severe.

Yadav says that with proper counseling, family support, and specialist treatment when needed, most patients show improvement. He stated that mental health problems are not a weakness. Like fever or other physical illnesses, timely identification and treatment are necessary.

Increasing Complications Due to Delayed Treatment
According to Dr. Tejnarayan Mahato, a psychiatrist at Provincial Hospital Janakpurdham, 30 to 35 patients with mental health issues come to the hospital for treatment daily. According to him, in recent years, the number of patients coming with mental problems due to anxiety, depression, insomnia, excessive stress, and the effects of drug abuse has increased.

'Many patients come very late for treatment. The tendency to hide mental illness or consider it a matter of social stigma still persists,' he said.

According to Dr. Mukti Narayan Shah, spokesperson for the Madhesh Province Ministry of Health and Population, efforts are underway to expand mental health services across the province. He said that there are 1,353 health institutions across the province, including private health institutions. He stated that training on counseling and identification of mental illness is being conducted in coordination with the Health Directorate.

'We have already procured medicines for mental illnesses. Free distribution is being prepared soon. Many patients improve with counseling alone, but we are arranging to provide free medicines to those who need them. We are also making necessary preparations for patients who require inpatient treatment in the coming days,' he said.

Change in Social Thinking is Necessary
According to experts, expanding mental health services at the primary health center level, mental health education from the school level, public awareness campaigns, and positive family support are extremely necessary.

Although statistics show an increasing trend in mental health problems, experts say that most problems can be controlled with timely identification and treatment. However, the problem is becoming more complicated due to social stigma, superstition, lack of specialists, and delayed treatment.

According to experts, the real challenge of mental health in Madhesh is not just the illness, but also the social perspective towards it. As long as mental illness is not accepted like other physical illnesses, many people will remain away from treatment.