Mental Health in Nepal: A Psychiatric's views
30 pc of population suffering from psychiatric problems: Dr. Shrestha
The Kathmandu Post: What are the commonest psychiatric problems faced by the patients coming to the hospital?
Dr. Shrestha: Patients suffering from mental retardation, epilepsy, psychosis (severe mental illnesses like schizophrenia, mania), behavioural problems and other psychiatric complications frequently come to this hospital.
All types of epileptic cases come to the hospital and they form the third biggest group of cases after neurotics (those suffering from mild illnesses like anxiety, depression) and psychotics (people suffering from psychosis). Moreover, cases of alcohol dependence come only when they have severe withdrawal symptoms such as delirium tremens (an acute delirium caused by alcohol poisoning), rum-fits or when they have psychotic features or depression. Similarly, among the drug dependent cases, mainly opiate (heroin and buprenorphine) dependent cases come for treatment but cases of cannabis use with psychiatric complications are also frequently seen in the hospital.
TKP: Do all types of patients get admitted in the hospital?
Dr. Shrestha: No, only those patients who are unmanageable at home and dangerous to self and others are admitted here. About 600 patients are admitted in the hospital every year and a vast majority of them are psychotics.
TKP: Is the hospital equipped enough to render the needed services to the people suffering from mental illnesses?
Dr. Shrestha: The most serious constraint in the hospital is the limited human resources. Although four psychiatrists and four medical officers are supposed to be there, virtually we have only two of each in the hospital. Moreover, currently there is no provision of clinical psychologists, psychiatric social workers, occupational therapists and psychiatric nurses in the hospital. This debilitates us in reaching out to those in need.
TKP: What are the other constraints that hinder in the service delivery?
Dr. Shrestha: Other constraints are the misconceptions people have about mental illness. Social stigma is attached to mental illness and mental patients. Paradoxically, this stigma is apparently more among the educated and elite group than among the illiterate and the general population.
We also suffer from the lack of psychiatric medications. There are absolutely no psychiatric medications in the primary health care centres, health posts and sub-health post levels. Furthermore, the frequent transfer of health workers has posed more problems in rendering service in a planned manner.
TKP: How serious is the government toward the promotion of mental health in the country?
Dr. Shrestha: About 30 per cent of the general population of the country usually suffer from one or other kind of psychiatric problems at any point of time. Despite such a high prevalence of mental illness in Nepal, mental health sector seems to be the most neglected by the government. Out of five per cent of total national budget that is allocated for the health sector, less than 0.2 per cent is allocated to the hospital. This is mainly because of the misconceptions and lack of knowledge about mental health among the planners and policy makers. Also the basic understanding among them is that unlike physiological illnesses or diseases, mental illnesses rarely takes one’s life. This also contributes to the negligence of the mental health sector by the government.
TKP: What is the overall scenario of mental illness in Nepal?
Dr. Shrestha: There is no separate mental health legislation in Nepal. The present law regarding mental patients and mental illnesses are grossly disorganised, outdated, unscientific and inhumane too.
Keeping this in mind, the Psychiatric Association of Nepal, in collaboration with the Mental Hospital, T.U. Teaching Hospital and United Mission to Nepal came with a draft bill on mental health, which was submitted to the Ministry of Health two years ago soliciting necessary action. Till now, the government so far hasn’t taken any step to pass the bill.
TKP: What do you think the government should do to improve the mental health situation?
Dr. Shrestha: I believe that the government should accord due priority to mental health services especially considering the high prevalence of mental illnesses in the country. It should also make a scheme to attract doctors to do post graduation studies in Psychiatry. Moreover, the government should immediately pass and implement the proposed mental health legislation so as to protect the rights of mentally ill patients.
Source: Nepalnews.com
The Kathmandu Post: What are the commonest psychiatric problems faced by the patients coming to the hospital?
Dr. Shrestha: Patients suffering from mental retardation, epilepsy, psychosis (severe mental illnesses like schizophrenia, mania), behavioural problems and other psychiatric complications frequently come to this hospital.
All types of epileptic cases come to the hospital and they form the third biggest group of cases after neurotics (those suffering from mild illnesses like anxiety, depression) and psychotics (people suffering from psychosis). Moreover, cases of alcohol dependence come only when they have severe withdrawal symptoms such as delirium tremens (an acute delirium caused by alcohol poisoning), rum-fits or when they have psychotic features or depression. Similarly, among the drug dependent cases, mainly opiate (heroin and buprenorphine) dependent cases come for treatment but cases of cannabis use with psychiatric complications are also frequently seen in the hospital.
TKP: Do all types of patients get admitted in the hospital?
Dr. Shrestha: No, only those patients who are unmanageable at home and dangerous to self and others are admitted here. About 600 patients are admitted in the hospital every year and a vast majority of them are psychotics.
TKP: Is the hospital equipped enough to render the needed services to the people suffering from mental illnesses?
Dr. Shrestha: The most serious constraint in the hospital is the limited human resources. Although four psychiatrists and four medical officers are supposed to be there, virtually we have only two of each in the hospital. Moreover, currently there is no provision of clinical psychologists, psychiatric social workers, occupational therapists and psychiatric nurses in the hospital. This debilitates us in reaching out to those in need.
TKP: What are the other constraints that hinder in the service delivery?
Dr. Shrestha: Other constraints are the misconceptions people have about mental illness. Social stigma is attached to mental illness and mental patients. Paradoxically, this stigma is apparently more among the educated and elite group than among the illiterate and the general population.
We also suffer from the lack of psychiatric medications. There are absolutely no psychiatric medications in the primary health care centres, health posts and sub-health post levels. Furthermore, the frequent transfer of health workers has posed more problems in rendering service in a planned manner.
TKP: How serious is the government toward the promotion of mental health in the country?
Dr. Shrestha: About 30 per cent of the general population of the country usually suffer from one or other kind of psychiatric problems at any point of time. Despite such a high prevalence of mental illness in Nepal, mental health sector seems to be the most neglected by the government. Out of five per cent of total national budget that is allocated for the health sector, less than 0.2 per cent is allocated to the hospital. This is mainly because of the misconceptions and lack of knowledge about mental health among the planners and policy makers. Also the basic understanding among them is that unlike physiological illnesses or diseases, mental illnesses rarely takes one’s life. This also contributes to the negligence of the mental health sector by the government.
TKP: What is the overall scenario of mental illness in Nepal?
Dr. Shrestha: There is no separate mental health legislation in Nepal. The present law regarding mental patients and mental illnesses are grossly disorganised, outdated, unscientific and inhumane too.
Keeping this in mind, the Psychiatric Association of Nepal, in collaboration with the Mental Hospital, T.U. Teaching Hospital and United Mission to Nepal came with a draft bill on mental health, which was submitted to the Ministry of Health two years ago soliciting necessary action. Till now, the government so far hasn’t taken any step to pass the bill.
TKP: What do you think the government should do to improve the mental health situation?
Dr. Shrestha: I believe that the government should accord due priority to mental health services especially considering the high prevalence of mental illnesses in the country. It should also make a scheme to attract doctors to do post graduation studies in Psychiatry. Moreover, the government should immediately pass and implement the proposed mental health legislation so as to protect the rights of mentally ill patients.
Source: Nepalnews.com
posted by OurNepal at
7:16 PM
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