Nepali Times
All in the mind


When I was 11, I started suffering symptoms of mental disorder: chronic headache, insomnia and feelings of hopelessness, isolation and lack of interest in studies.

But such is the social and family stigma towards mental disorder that I kept it hidden from my family. I felt guilty about my deteriorating health and had suicidal thoughts. There was no one with whom I could share my sense of hopelessness.

Because of my belief in spiritualism I couldn't kill myself, but opted to poison myself slowly with alcohol and smoking. I went to doctors, but their dismissive and humiliating behaviour made me feel worse. Where to go? Whom to talk to? What to do?

At 15 I started taking neuro-psychiatric medicines along with the alcohol and smoking. But after 12 years, I stopped these and turned to yoga and alternative therapies. Slowly, I emerged from the darkness. As I got healthier, my faith in these methods grew and I started sharing my concerns with my family members who supported my recovery.

Since then, I have decided to devote myself to showing others that mental disorder is not a dead-end street, we can will ourselves to come out of it. There is a lot to struggle against, but the biggest barrier is society's ignorance about mental health and the stigma attached to it. The extent of the problem in Nepal is staggering:

* 20 per cent of the population is affected by some form of mental disorder, and this dwarfs any other disease
* Yet, only 0.15 per cent of the health care budget is spent on mental health
* There are only 40 licensed psychiatrists and five clinical psychologists for a population of 28 million people
* Traditional healers are primary care givers
* There is extreme stigmatisation and ostracisation
* Mental health is a human rights issue because many patients are sent to jail because of their illness
* Mental health is not a priority for the donor community
* Out of six people with disabilities, four have mental disorders.
* The UN Convention on the Rights of Persons with Disabilities was signed in May this year to promote the human rights of people living with mental or physical disabilities.

Usha is now 46 years old. She went into deep depression after the birth of her second child twenty years ago. Her family thought she was possessed and sent her to a jhankri. Fearing loss of prestige, Usha's husband settled her in another house and married again.

Later, she was diagnosed with common post-natal depression which has a 100 per cent chance of recovery. The only barriers to her treatment were ignorance and prejudice.

Our social attitudes, education and health care clearly deny the importance of mental health for individual and collective growth. This insensitivity creates a deep silence and great injustice by its avoidance of mental health issues.

There is no human rights review board with the authority to inspect mental health facilities. Instead, mentally ill people are locked up in jail or they are treated in semi-prisonlike isolated care systems.

There is a close relationship between mental illness and gender bias, social exclusion, alcoholism, drug addiction, HIV/AIDS, suicide, unemployment, illiteracy, natural disaster, poor health and family violence. In Nepal, conflict trauma, poverty and political turmoil are also reasons. Yet, the voices of these people and their families are never heard in discourse about social, political, and human rights.

In the past year, I have found friends and supporters within Nepal for the cause of mental health. Let us hope that in a 'new' Nepal, the state and society will promote justice and equality and extend priority to the mental health of Nepalis.

This Dasain, let's commit ourselves to this goal on World Mental Health Day on 10 October.

Jagannath Lamichhane is the founder of the Nepal Mental Health Foundation jagannathlc(at)

(11 JAN 2013 - 17 JAN 2013)