Mental health in Nepal: Cultural beliefs, stigma, and social silence

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

Congress sailing without a star

Once regarded as the trailblazer of democracy, the Nepali Congress now faces an existential crisis. With the party lurching toward a further delayed general convention and finding itself adrift in an ideological void, a troubling question has emerged. What is the Congress party actually for in modern Nepal? The current situation is not merely an organizational failure or a temporary leadership crisis but a fundamental breakdown in the coherence, purpose and political relevance of the party. The Congress must urgently undertake a radical ideological clarification or face irreversible decline into historical irrelevance. 

Institutional failure

The most damning indictment of the party is deceptively simple. Since its 14th General Convention in Dec 2021, the party has been required to hold its 15th convention within four years. However, as of Dec 2025, it has failed to conduct this basic organizational function. This failure cannot be taken as a minor scheduling issue but as a major failure of institutional governance and political competence. The Congress leadership fractured between the Deuba-Khadka establishment faction, and the ‘reformist’ bloc of Gagan Thapa, Bishwa Prakash Sharma and Shekhar Koirala has spent months engaged in mutual obstruction and political brinkmanship. The reasons offered are revealing in their inadequacy. “Technical and logistical reasons,” “complications in the distribution of active membership” and “improper serial numbers on membership forms.”

These excuses would be laughable if they were not so pathetic for a party that claims to represent democratic values. Even 54 percent of the elected convention delegates, well exceeding the statutory 40 percent threshold, had already submitted signatures demanding a special convention.

The central committee was legally obligated to call the convention within three months of receiving such a demand. However, the central committee meeting that began in mid-October simply extended indefinitely, with no resolution in sight. The Deuba-Khadka faction openly preferred to postpone the convention until after the general election transparently attempting to extend their own terms (for whatever reasons) and avoid accountability. Up to the point, it is no longer just institutional inefficiency but institutional paralysis. A political party that cannot organize its own internal democratic processes has forfeited the moral authority to claim democratic credentials. The Congress, which once championed the democratic revolution of the country and led the Jana Andolan movements, has become a cautionary tale in the corruption of organizational purpose by factional ambition. 

Ideological incoherence 

The Congress faces a more profound crisis. Ideological incoherence that borders on the farcical. The party constitution officially identifies Congress as a “social democratic” party committed to “democracy and socialism.” However, this declaration clashes with its post-1990 practice and its current political alignments. BP Koirala articulated a clear vision of democratic socialism as a middle path between capitalism and communism. Koirala explicitly rejected “unbridled consumerism” as immoral and opposed exploitation of resources as short-sighted. He believed that “only socialism could guarantee political freedom and equal economic opportunities to the people.” This was not theoretical posturing; it rather reflected a genuine philosophical commitment to combining political democracy with economic justice. 

Nevertheless, after the 1990 democratic restoration, Congress governments systematically embraced neoliberal economic policies that directly contradict these founding principles. The party implemented structural adjustment programs dictated by the World Bank and IMF. State-owned enterprises were privatized. Trade was liberalized. Import restrictions were eliminated. The Industrial Policy of 1992 and subsequent Foreign Direct Investment policies actively promoted private sector dominance. By the 2000s, Congress was overseeing an economy increasingly shaped by finance-led growth, import dependence and widening inequality; developments that marked a departure from the socialist vision. This contradiction might have been tolerable if Congress had at least articulated a coherent new ideology. 

Perhaps Congress could have honestly declared itself a social democrat in the Scandinavian sense supporting capitalism with robust welfare provisions. Or perhaps it could have embraced liberal democracy while accepting market economics. But Congress did neither. It clung verbally to “democratic socialism” while practicing almost liberalism creating a credibility chasm between principle and practice. By 2025, this incoherence reached absurdity. Congress partnered with communist parties—first the Maoists then the CPN-UML—to form coalition governments. The party whose founder rejected communism as an improper path to justice governed alongside self-identified Marxists. The party that privately embraced capitalism after 1990 publicly claims socialist credentials while their communist coalition partners theoretically pursue socialist transformation. 

The finance minister and other key economic policymakers navigate between fundamentally incompatible ideological frameworks with no coherent government economic policy to guide them. This intellectual dishonesty is staggering. How can a party claiming to be a social-democratic partner with communist parties while also being the practical architect of 35 years of almost neoliberal restructuring? How can Congress credibly advocate for any economic vision when its actual practice contradicts its stated ideology, which contradicts its communist coalition partners’ stated ideology? The answer is: it cannot. This is not flexibility or pragmatism. This is ideological bankruptcy masquerading as coalition management.

The rise of alternatives 

Perhaps most alarming for Congress is the emergence of political alternatives that have started to offer clearer ideological positioning. The Rastriya Swatantra Party (RSP) has now crystallized as a new centrist liberal force that explicitly commits to “a liberal economy with social justice.” RSP leader Rabi Lamichhane and Kathmandu Mayor Balendra Shah have just announced a “Grand Unity” agreement pledging to implement deep reforms and transform Nepal into a “respectable middle-income country within the next decade” through merit-based governance and youth-led renewal. Even though a broad interpretative commentary on this understanding is necessary and on the RSP itself, for now this represents a direct challenge to Congress’s political space, and it has already challenged the Congress with a growing number of its members and even prominent figures choosing RSP as an alternative. 

If voters are seeking a centrist, market-oriented party with democratic credentials, RSP now offers this without the baggage of years of contradictions. If voters are seeking reform and anti-corruption politics, RSP, despite its challenges, projects youth and renewal. Meanwhile, Congress remains trapped in aging factional disputes between Deuba, Koirala and Thapa, with no fresh ideas or new generation breaking through. By this I do not mean to portray that RSP is the one that will replace Nepali Congress ideologically but it may in terms of the voter base reflecting the liberal views. 

In India, the Congress party similarly lost its historic centrist space to the BJP on the right and to regional parties on the left. Nepali Congress faces an equivalent threat. The very political niche Congress once dominated, that is democracy, developmental capitalism, and secular nationalism is being colonized by newer parties that do not carry the baggage of neoliberal failure and communist coalition compromises. 

A party at a dead end? 

Congress has precisely one political lifeline remaining: radical ideological clarification undertaken immediately and with brutal honesty. The party cannot continue claiming to be both capitalist and socialist, both anti-communist and communist allies, both market-liberal and social democratic. Nevertheless, Nepali Congress remains indispensable to the long-term political and economic fabric of the country against the radical newcomers. This moment might even position Congress to lead through another defining crisis of battling the new danger of populism increasingly portrayed by newer parties whose charismatic appeals mask factionalism and untested governance, who are the textbook example of ‘simulacra and hyperreality’. 

Congress must make three not-so-difficult choices. 

Institutional renewal: Congress must conduct its delayed general convention with full transparency and embrace the GenZ-driven demand for new leadership. The party should commit to term limits, merit-based advancement and ideological clarity rather than factional rotation between aging elites. 

Ideological declaration: Congress must publicly acknowledge that post-1990 liberalism either succeeded or failed as a development strategy. If it succeeded, Congress should rebrand as an explicitly market liberal party committed to capitalism with welfare provisions essentially the Indian Congress model embracing “inclusive capitalism.” If it failed, Congress should articulate what economic vision should replace 35 years of liberalization. This honest accounting is a prerequisite to political credibility. 

Coalition coherence: Governing with Marxist-Leninists while trying to implement liberal policies is not pragmatism-it is a political fraud. Either Congress should unite with socialist parties around a genuine social agenda or it should form centrist-liberal coalitions. The current arrangement deceives everyone. 

The clock is running 

The party that led multiple democratic revolutions, that resisted dictatorship, that articulated a vision of democratic socialism suited to Nepali aspirations now risks becoming a historical artifact, a museum piece of failed leadership and ideological cowardice. The window for renewal remains open, but barely. RSP has increasingly captured the initiative for reformminded politics. 

Communist parties command the left. Congress occupies an increasingly narrow and indefensible middle ground. If Congress does not urgently undertake radical ideological reconstruction, conduct genuine democratic renewal and offer voters a coherent vision of Nepali economic future, then the party will not simply lose elections. It will lose its reason for existing. 

The founding generation of the party sacrificed imprisonment, exile and health to establish democracy in Nepal. The current generation owes it to them and to the future to answer honestly. 

What is Congress up for in 2026 and beyond? 

Until that question is answered with clarity, unity and humility, the decline will continue not as a dramatic collapse, but as a slow fade into irrelevance. And that may be the cruellest fate of all: not to be defeated, but to be forgotten leaving the nation ever more vulnerable to the populist chaos.

Defending the bench while demanding reform

The growing trend of using social media to attack courts, judges and, to some extent, legal professionals through personal abuse, ridicule and targeted humiliation is deeply troubling. Such conduct corrodes public discourse, undermines respect for institutions and risks normalizing intimidation as a form of expression. There is no justification for criminal, obscene or socially degrading speech aimed at individuals discharging constitutional responsibilities. This phenomenon deserves clear condemnation.

Yet condemning toxic expressions alone is not enough. A more uncomfortable but necessary question must also be asked: has the failure to openly and timely address the distortions, inconsistencies and internal weaknesses within the judiciary and the legal profession itself created fertile ground for this outburst of resentment on social media?

For years, concerns about the judiciary have circulated quietly—sometimes in academic circles, sometimes in private conversations among lawyers, journalists and citizens. These concerns range from opaque and non-transparent appointments to questions about intellectual rigor, professional competence, ethical consistency and accountability of some judges and legal actors. There are also deeper anxieties about institutional culture: delays in justice, selective urgency, perceived influence of power and proximity, and an erosion of public confidence in fairness. When such issues are repeatedly brushed aside, minimized  or metaphorically swept under the carpet, frustration does not disappear—it mutates.

Social media, with all its flaws, has become the outlet for that mutation.

It is important to be clear: abuse is not critique. Personal attacks are not reform. Threats and insults do not strengthen democracy. But neither does enforced silence. When legitimate debate about institutional shortcomings is discouraged, delegitimized or branded as contempt, the space for reasoned criticism shrinks. What rushes in to fill that vacuum is often anger—raw, unstructured, and destructive.

This is not unique to the judiciary, nor to Nepal. Across democracies, institutions that resist introspection tend to lose moral authority. Respect cannot be demanded indefinitely; it must be renewed through performance, integrity and openness to scrutiny. The judiciary, precisely because it wields immense power over liberty, property and rights, must be held to the highest standards—not only by law, but by public expectation.

A mature democracy distinguishes between malicious attacks and principled criticism. It protects judges from intimidation while allowing citizens to question systems, decisions and processes. It understands that reverence without accountability breeds stagnation, while criticism without responsibility breeds chaos. The challenge lies in holding both truths at once.

Continuous review, honest self-critique and institutional reform are not threats to judicial independence; they are its foundations. A judiciary that welcomes evaluation—of appointment procedures, training standards, ethical enforcement and transparency—signals confidence, not weakness. Conversely, one that appears defensive or closed risks alienating the very public whose trust it requires to function.

Legal professionals, too, must look inward. The bar is not merely a defender of the bench; it is a bridge between law and society. When lawyers dismiss public concerns outright or circle wagons without addressing substance, they inadvertently deepen the credibility gap. Reform is not betrayal; it is responsibility.

Social media excesses must be checked through law, norms and collective ethics. But reform cannot begin with censorship alone. It must begin with acknowledgement: that there are unresolved issues within the justice system, that some criticisms—when stripped of their abusive packaging—point to real grievances, and that postponing reform only amplifies discontent.

A capable, dignified and trustworthy judiciary does not emerge from denial. It takes shape through constant reflection, principled criticism, and a willingness to correct course. If we truly seek to restore respect for the courts, the answer lies not in silencing voices, but in strengthening institutions—so that criticism becomes measured, trust becomes earned and justice becomes visibly, consistently fair.

Only through sustained review, reform and openness can an ignored ideal be transformed into a living, credible justice system—one that commands respect not by fear or distance, but by integrity and performance.

Security at the time of polycrisis

In a technology dominated global system, when the interests of one country overlap with those of others, conflict rises and crises emerge. The crises are entangled with various sectors of state affairs such as politics, technology, economy and social development. Crises emerge not only at the global level but also at the national level. In many cases, a small event can trigger painful consequences. In a democratic system, state affairs are delicate in nature as they are meticulously linked with people’s aspirations. If these aspirations are not fulfilled, disruptions escalate rapidly. Prior to the 1990s, the world was mainly divided along ideological lines—capitalism and communism, steered respectively by the USA and the then Soviet Union.

In the present day of the 21st century, situations have dramatically changed, as developed countries are locked in unhealthy geopolitical competition to increase and expand their traditional means of state power. The seen and unseen rivalry has no longer focused on strengthening their military power alone, rather they have concentrated their entire activities on economic dominance influencing and coercing others by fair means or foul. Thus, being a consequence of global interconnectivity, the polycrisis neologism has captured the present-day state affairs.

Vulnerabilities

Nepali GenZ (Nava Pusta) protests of Sept 2025 were largely based on non-political ideologies in nature. The protests were primarily rooted in structural economic grievances, antediluvian working style of established political parties and poor service delivery of the government.

A weak national economy, heavy dependence on remittances and foreign loans, ineffective governance, poor implementation of public policy and frequent changes in federal and provincial governments resulted in challenges of unemployment, inflation, corruption and a trust deficit in political parties, fueled widespread dissatisfaction among the Nava Pusta.

The collapse of the entire federal government within just two days of Nava Pusta’s protests was an unprecedented incident in the political history of Nepal. However, the destruction of government physical infrastructures, and public and private property through arson by anti-national elements (who were not genuine members of GenZ) cannot be condoned and pardoned.

The changes that took place after the Nava Pusta movement shuddered the foundations of established political parties were significant. The  international media labeled the protests as a ‘color revolution’. Whether this was truly a ‘color revolution’ or simply GenZ-led protests remains a matter of academic discourse. The former Home Minister’s statement given before the High Level Investigation Commission clearly points to direct influence of foreign elements in the peaceful GenZ protests. But the wave created by these protests has had a long-lasting tremor. The political instability in a geopolitically sensitive country has created a space for different actors who have hidden agendas to exploit Nepali soil and politics for their benefits, and is a serious threat to national security.

At this point of critical juncture, a single issue can spiral into a polycrisis. It can trigger the erosion of public trust in democratic institutions, leading to ineffective crisis response and governance paralysis. Security, in such a polycrisis situation often becomes reactive rather than strategically active. Nepal’s security needs to be active and agile to ensure that the Nepali people are competent enough to handle their internal challenges independently. The Nepali people and leadership alike must act accordingly so that no external power gains a foothold in the country’s strategic decision-making processes—directly or indirectly.

To demonstrate one’s capability to manage internal issues independently, requires the application of strong security measures backed by accurate information, use of advanced technology, coordinated strategic planning and action, and high-morale security personnel. The security organizations must have the ability to anticipate the future, not just respond to it. Experienced and highly skilled security officers are crisis managers, risk analysts, strategic communicators, and protectors of national interests and sovereignty. They are not merely the persons in uniforms rather they are the backbone of state security and stability.

Driving seat

Citizens are the first to bear the effects of polycrisis. The interwoven challenges in the  economy, society and governance can escalate into a full-blown crisis at any time that requires more vigilance in national affairs.

Sometimes, voices appear in the media alleging that the country—X has played a foul game by intervening in Nepal, provoking public agitation against the government and fueling conflict among the castes and social class. Diplomatically, it is not wise to allege Country X or Y, while ignoring the need to analyze and address domestic causes and their impact in society. Instead of pointing fingers at others, the government, political parties and concerned authorities should mend flawed policies and change outmoded mind-sets, and ensure good governance for the well-being of citizens and the nation at large.

It is natural for Country X or Y to take all necessary steps to safeguard their national interests. If they believe that by destabilizing a weaker country serves their purpose, they leave no stone unturned to fish in troubled waters. This is a routine work of  global diplomacy.

Ultimately, it is the major responsibility of Nepali political parties who hold the reins of state governance to keep their own house in order. They must foster harmonious relations within Nepali society and among common citizens, keeping in mind the age-old saying—Anekata Ma Ekata, Nepali Samaja Ko Biseshata (Unity in Diversity is the defining characteristic of Nepali Society).

Sustained economic development, a secure civil society, transparent practices, good governance, effective security organizations, and justice for all will help to keep foreign elements at bay. When the entire society upholds a value-based system rooted in patriotism and ethics no external force dares to rock the boat or destabilize the nation.