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Mental health is recognized by the World Health Organization (WHO) as a vital element of overall well-being, encompassing emotional, psychological, and social aspects that determine how individuals think, feel, and act throughout their lives. According to the Center for Disease Control, it is not just about the absence of a mental health condition, but it is also about the presence of well-being and the ability to thrive.  WHO warns that globally, mental health issues are emerging as leading causes of disability and poor quality of life, with approximately one in seven people living with mental disorders each year. Mental health has increasingly emerged as a critical public health challenge in Nepal. A combination of high prevalence of mental disorders, limited access to services, and persistent social determinants has created a significant treatment gap that undermines individual well-being, productivity, and overall national development. According to a 2023 analysis, approximately 3.9m Nepalis were estimated to be living with at least one mental disorder in 2019. This translates into a marked rise in the burden of mental disorders over the past three decades: the proportion of disability-adjusted life-years (DALYs) attributable to mental disorders in Nepal has nearly tripled from 1990 to 2019.  A nationally representative study published in 2016 shows that among Nepali adults (aged 18–65), both anxiety and depression are “very highly prevalent” and often comorbid. Per a 2024–2025 study of over 12,000 individuals found gender disparities, women had significantly higher point-prevalence of anxiety (21.9 percent vs 11.3 percent) and depression (5.4 percent vs 1.7 percent) than men in Nepal. Social dimension A study found that social determinants significantly influence mental health outcomes in Nepal. Poverty, unemployment, early marriage, gender-based violence, and caste-based discrimination contribute to chronic stress and reduced well-being, especially among women and marginalized communities. Labor migration, involving nearly four million Nepalis working abroad, often leads to family separation, loneliness, and emotional strain among both migrants and those left behind.  Women are particularly vulnerable due to restrictive social norms, financial dependency, limited autonomy, and the stigma associated with disclosing emotional distress or seeking care. Youth populations face rising mental health issues driven by academic pressure, unemployment, and social media-related stress, yet few youth-centered services exist. Kohrt & Harper (2008) argue that stigma continues to be one of the most pervasive barriers to mental health care in Nepal. Strong cultural norms that attribute mental illness to “karma,” spirit possession, or personal weakness reinforce labeling, shame, and social exclusion. Those experiencing mental health problems are often called “paagal” (mad), a term that carries deep social stigma and undermines one’s dignity, identity, and social value. Such stigma not only discourages individuals from seeking care but also results in discrimination within families, workplaces, and communities.  A study by Luitel et. al (2017) demonstrates that stigma is among the top structural barriers preventing individuals from accessing mental health services in Nepal. Conversely, upholding human dignity requires dismantling mental health stigma, recognizing individuals with mental health conditions as possessing equal inherent worth, protecting their agency in health decision-making, and creating the material and social conditions in which they can exercise substantive freedoms and participate fully in community and family life. Cultural beliefs, stigma, and social silence Cultural beliefs and social norms play a decisive role in shaping how mental health is understood, discussed, and responded to in many societies. Across the world, stigma often arises when mental illness is interpreted through moral, spiritual, or supernatural lenses rather than as a legitimate health condition. Such interpretations can influence whether individuals seek treatment, how communities treat people experiencing psychological distress, and whether families disclose mental-health problems or hide them due to fear of judgment. In contexts where collective identity and social harmony are highly valued, stigma can deepen because mental illness is seen not only as an individual issue but as something that threatens family reputation or social standing. Cultural beliefs and social norms in Nepal play a powerful role in shaping how mental health is understood, interpreted, and treated. These beliefs influence not only how individuals experience psychological distress but also how families and communities respond to such conditions. It is evident that in many parts of Nepal, mental illnesses are not viewed primarily as biomedical conditions but are instead interpreted through religious, spiritual, and moral frameworks. These culturally embedded interpretations often reinforce stigma and undermine human dignity. Traditional beliefs such as spirit possession, witchcraft, and the influence of supernatural forces remain common explanations for mental distress. Kohrt & Harper (2008) see many communities attribute symptoms of psychosis, depression, or schizophrenia to spirits being displeased. Such interpretations often lead families to seek help first from traditional healers including dhami-jhankri, lama, or tantric practitioners rather than mental health professionals and sharing to peers. While these healers provide culturally meaningful support, delays in receiving clinical care can worsen individuals’ conditions and reinforce the idea that mental illness is anomalous or spiritually polluted.  Beliefs in karma that a person’s suffering results from past sins or moral failings further moralize mental health conditions and contribute to blaming the individual. Stigma is deeply intertwined with the cultural lexicon. Individuals experiencing mental health issues are often labeled as “paagal” (mad), “sano dimag” (small-minded), “nasamjhine” (irrational), or “kamjor” (weak). These labels carry strong social judgment, implying unpredictability, incompetence, or danger. The use of such derogatory terms reflects a social narrative that reduces a person’s identity to their mental condition, directly undermining their autonomy, agency, and dignity. Such labeling results in “structural violence,” where individuals are excluded from education, employment, and social participation due to perceived inferiority. The fear of shame (lajjā) and the desire to preserve family reputation (ijjat) further intensify stigma. Family honor remains central within Nepali society, and mental illness is often viewed as a threat to the household’s social standing. This leads many families to hide symptoms, avoid seeking help, or restrict the affected individual’s mobility. Women are disproportionately affected: because they are commonly blamed for causing disharmony, family problems, or “inviting” misfortune, their distress is seen as a personal failure rather than a health condition. In some cases, women are subjected to verbal abuse, restriction of autonomy, or even abandonment due to mental illness, reflecting highly gendered forms of stigma. Shawon et al. (2024) studied mental health through gender aspects and found that women who express emotional suffering may be labeled as ‘overly sensitive’ or ‘weak’, while men may face stigma for failing to embody cultural expectations of strength and emotional control. In patriarchal households, women’s suffering is often minimized or dismissed as normal emotional fluctuation, linked to menstruation, pregnancy, or household stress. This silencing hinders early identification and reinforces unequal power dynamics. Because of these cultural pressures, many individuals opt for alternative healers before turning to biomedical services. For countries like Nepal, where social stigma, poverty, foreign migration, gender inequity, and weak health systems intersect, the mental health challenge is even more urgent. The evidence reviewed in this article shows that mental health struggles in Nepal are deeply tied to vulnerability: individuals who are socially excluded, economically fragile, or culturally marginalized face disproportionate risks of distress and also bear the heaviest weight of stigma. These vulnerabilities do not exist in isolation but accumulate across family life, livelihoods, social belonging, and access to care. Understanding these dynamics is essential for promoting dignity-centered mental health interventions that respect cultural contexts while challenging harmful stereotypes. The author is a graduate student of Global Affairs at the University of Notre Dame, USA