Mental health crisis: A national-level threat being ignored

Nepal’s mental health crisis is a ticking time bomb, and the government is doing nothing to defuse it. While politicians line their pockets, thousands of Nepalis are dying from preventable suffering. This is not just gross negligence—it’s a national disgrace.

A reality check

The severity of Nepal’s mental health crisis is heavily undermined. The statistics alone should spark an outrage: nearly 10 percent of Nepalis are living with mental health disorders, ranging from depression and anxiety to bipolar disorder and schizophrenia (Nepal Health Council in 2021).

The tragic reflection of our society is mirrored by adolescents, a demographic with the highest vulnerability to death by suicide. From 2022 to 2023, on average, 19 people died from suicide every day in our country, and countless others have continued to silently endure debilitating mental health challenges without access to care or support. 

According to reports by the World Health Organization (WHO), Nepal has one of the highest rates of psychological distress and disorder in the demographic of South Asia.

Adding insult to injury, the government allocates less than one percent of its health budget to mental health services. This abysmally low investment paints a clear picture of where mental health ranks in the country’s list of priorities: at the bottom.

The compounding factor lies in the country's education system and healthcare system, where there is no awareness regarding mental health crises and the country lacks the infrastructure and human resources to deal with these psychological disorders.

Systemic failure

Nepal’s healthcare system is laughable to be brutally honest. Mental health services remain concentrated in a handful of urban centers, leaving rural populations entirely neglected. For many Nepalis, accessing care is not just difficult—it’s impossible.

The situation is further worsened by a lack of professionals in the given area. As per reports by WHO (2021), for every 100,000 Nepalis, there were only 0.17 psychiatrists, 0.03 psychologists and 0.21 mental health nurses. Moreover, a concerning number of the available professionals that we do have are arguably not qualified to diagnose or treat patients. There is a glaring lack of a formal licensing board that standardizes counseling and therapy practice and regulates practitioner behavior. This absence of professionals and professionalism leaves individuals to struggle in silence until it is often too late.

Even in urban areas, the services available are prohibitively expensive for most Nepalis. Mental healthcare is treated as a luxury reserved for the wealthy, rather than a fundamental right for all citizens. The government’s promise to integrate mental health into primary healthcare remains nothing more than hollow words. Most primary healthcare centers don’t even have the resources or training to handle basic mental health cases.

Physiological and psychological health are treated with different intensities and attitudes in Nepal. While it is easy to almost unconditionally nurture and care for someone with a broken arm, it’s often much harder to even acknowledge when someone is struggling on the inside.

Societal stigma

Societal stigma plays a vital role in the current situation of Nepal’s mental health crisis. Mental illness is often perceived as a personal failure or a fatal flaw in character, a punishment for bad karma, possession by spirits, or even bluffing to dodge responsibilities. Such regressive beliefs isolate those who are already vulnerable, forcing them to suffer in silence.

Families hide mental health issues out of fear of ostracization. Communities badmouth “crazy” individuals, dismissing their struggles and calling them names instead of being empathetic, let alone offering help. This stigma creates a suffocating environment where people would rather endure silently than seek support, fearing that a diagnosis will label them as a “psycho”  for life.  The wider society has already consolidated the complex and diverse spectrum of psychological disorders into psychosis—most representations of mental illnesses in media are often portrayed through debilitating conditions such as schizophrenia and other delusional disorders, where affected people are always hallucinating, acting aggressively, catatonic, harming themselves or others or not maintaining personal hygiene. However, books like the DSM-5 and ICD-11, which have been continually revised by leading experts, suggest that there are multiple mental health disorders that each have their own onset, severity, prevalence, and prognosis which can greatly vary according to the set categories.

The lack of open conversation about mental health perpetuates this toxic culture. Schools avoid teaching students about emotional well-being, and the media rarely portrays these issues with the sensitivity they deserve. Instead of being a society that supports and uplifts, Nepal has become one that shames and silences its own people.

Governmental apathy

The government’s efforts toward the mental health crisis are outright shameful and borders on recklessness. The National Mental Health Policy, created in 1996, is tragically outdated and barely implemented. It exists more as a formality than as a functional framework to address the crisis.

The promises to integrate mental health into primary healthcare by politicians remain unfulfilled. Hospitals and clinics lack the resources, trained staff, and infrastructure needed to support even the most basic mental health services. 

This apathy directly costs lives. Suicide rates are climbing, untreated mental illnesses are becoming more severe, and the stigma around mental health continues to grow unchecked. Yet policy makers remain silent, hiding behind empty rhetoric while their citizens suffer.

The message is clear: the government has chosen to abandon its people in their time of greatest need. This neglect is not just a policy failure—it is a betrayal of the fundamental duty to protect and care for the nation’s citizens.

What shall we do?

Boost the budget’s allocation

It is impossible to address mental health without a substantial financial commitment. Mental health services must get a significant amount of the government's health budget. Building infrastructure, employing experts, and providing treatment subsidies to those who cannot afford them.

Increase the infrastructure for mental health

To guarantee accessibility across the country, all district hospitals should have mental health units. They should educate primary care providers on how to identify and handle common mental health conditions. There must be a provision of at least mobile mental health clinics for isolated and rural locations.

Start campaigns for public awareness

There must be bureaucratic and civil interest in running and participating in national campaigns to raise awareness about mental health issues via social media, television, and radio. We should make an effort to de-stigmatize mental illness, promote candid discussions, and spread the word that getting assistance is both necessary and normal.

As much as we would like to point fingers and shift the blame onto a particular body or individual, it is obvious that we are just as much at fault when it comes to society’s unwillingness to change. Our compliance and comfort in the fact that the system continues to alienate and vilify people who clearly need support has led to a divide that threatens to unravel our moral fabric. Unless we persistently challenge our crude ideologies and those in power who seek to reinforce them, we will never truly be able to progress as a collective or achieve equity.

Ujain Shrestha

A-levels 

Islington College, Kathmandu