29 November-5 December 2013 #683

Peace of mind

A former patient is rehabilitating others like him and changing society’s perception of mental illness
Ayesha Shakya

THE CAREGIVER: Matrika Devkota opened Koshish in 2008 to help rebuild the lives of mental health patients who have been abandoned by their families. Currently, the protection home in Ekantakuna (below) houses 13 women, including four with children, and three men.
Matrika Devkota was 15 when he first started suffering from symptoms of depression: long periods of sadness, fatigue, loss of appetite, difficulty concentrating at school. He visited doctors in his hometown of Gorkha, but they were dismissive and told him that he was just going through a normal teenage ‘phase’. “It was the darkest time of my life. I knew I needed help, but didn’t know where to go,” recalls Devkota.

After spending years in isolation with little support or understanding from friends and family, Devkota was finally able to give a name to his illness at 25. His sister-in-law took him to the Mission Hospital in Gorkha where he was diagnosed with chronic depression. It took him only five years of therapy and medication to make a full recovery. With an ISC degree in forestry, Devkota began working as a forest ranger in Dang. But something did not feel right. He quit his job and decided to dedicate his life to rehabilitating mental health patients and helping them lead independent and fulfilling lives.

Devkota started out by caring for homeless patients from a one room office in Lagankhel. Then in 2008, he opened an NGO called Koshish which focuses primarily on women and children who have been abused and abandoned. The organisation also works to increase understanding of mental disorders and remove the stigma and prejudice that prevents patients from being active and equal members of society.

Currently, the protection home in Ekantakuna houses 13 women, including four with children, and three men, all of whom are looked after by a dedicated group of staff comprising of nurses, caretakers, a psychologist, and a psychiatrist.

The 42-year-old’s unwavering commitment to improving the quality of life of mental health patients earned him the prestigious Dr Guislain ‘Breaking the Chains of Stigma’ award in October this year. The award is given to people, projects, or organisations around the world that have made ‘exceptional contribution in dealing with, or promoting the attention for mental healthcare’ and comes with $50,000 prize money.

“We want mental health to be a part of general health,” explains Devkota. “The first step in bringing about this reform is to close down mental hospitals, which still carry a great deal of stigma, and replace them with separate mental health facilities. This way we can integrate treatment and also reduce the shame that patients face.”

While individual advocates like Devkota play a vital role in promoting mental healthcare in Nepal, the state’s efforts in the field have been abysmal. The government introduced a Mental Health Policy in 1997, which aimed to make services available to the general population by 2000. More than a decade later, there is little to show for. The Ministry of Women, Children, and Social Welfare has pledged Rs 500,000 to Koshish. But donations to private organisations are of little use when there are no long-term plans in place.

Less than one per cent of Nepal’s total health budget is allocated for mental health. Most of this money goes to the 50-bed Mental Hospital in Patan. The facilities are too meagre to accommodate growing demand. There are only 32 psychiatrists and a handful of clinical psychologists and psychiatrically trained nurses in the country, mostly in cities.

In order to have well-trained professionals, better facilities, and develop a more sensitive approach to mental illness both the state and individuals like Matrika Devkota have to work as partners.