How community mental health works in Nepal.

The view of our Bangladesh team.

The project team behind the Mental Health programme in Bangladesh has visited Nepal, to explore what is happening in other places to support people with mental health issues. 

11.08.2016 by Mahajabin Khan
From the field

The community-based Mental Health initiative, implemented by ADD international in Bangladesh, is ensuring mental health services are available in local communities. ADD International is the first organisation in Bangladesh trying to introduce the idea of mental health at community level.

However, we can learn a lot by our neighbouring country Nepal, where several organisations are working on mental health issues, following a model introduced in 2009. This is why our team working in Bangladesh went to Nepal this year, to gain knowledge and experience on how to work in communities on this issue.

Why Nepal?

Nowadays, mental health is a buzz issue in the health sector – and it is a social issue that has been neglected for many years. Many countries of the world are now working to promote mental health, but Bangladesh has been left behind.

Bangladesh however is quite similar to Nepal with regards to cultural activities and socio-economic status. We thought that – if they’ve managed to progress hugely in providing community mental health services – we can definitely use their knowledge and experiences to grow similar services too.

Moreover, it’s always important to disseminate positive learning and experiences with other people operating in the disability rights’ sector. Knowledge and information is useless until you are not sharing it with more and more people – and this is particularly important for mental health, as it is a relatively new area of work. 

A window, with flowers

The home of one of the people with Mental Health issues we visited in Nepal.

Our visit.

We visited a Nepalese NGO called Livelihoods Education and Development Society (LEADS). Their work promotes the rights of people with mental disorders and their caregivers, and helps them with their immediate needs and livelihoods. Currently its mental health and development programme is implemented in Baglung and Myagdi, both hard to reach areas of Nepal.

During this visit the team has also visited CBM partner’s activities on mental health.

Myths and the importance of awareness.

The socio-economic situation of Nepal is quite similar to Bangladesh’s. Cultural practices are also similar, although people in the areas where we have visited seemed very open and their religious beliefs didn’t seem to create barriers to make them aware regarding mental health issue. How much have awareness campaigns helped in this?

One person with a mental health condition who is now taking medicine said that,

‘People always used to believe that my illness was curse of god. When a person got depression, the community would ignore and exclude that person. Now, we are in a better condition. At least they recognise it as a health problem.’

Women and mental health in Nepal.

Like in Bangladesh, women are more affected by mental illnesses compared to men.

But we have learnt that the attitude is slightly different from Bangladesh – they suffer mostly from depression or anxiety, but the remarkable thing is, they are very concerned about their own wellbeing. When LEADS conducts awareness consultation in villages, people recognise that the problem has been existing among them or within society. So when LEADS arranges health camps, people actively go there to seek help and get treatment.

Mental Health beneficiary in Nepal
people walking through a beautiful mountain scenary
A woman

We've visited a number of homes in Nepal, and communities where people with mental illnesses receive services. (None of them is shown in the photos, to protect their privacy)

LEADS’ focus on gender equality and caregivers.

LEADS works in two districts where they have two associations and two cooperatives. Most of the higher positions, such as president or secretary, have been occupied by women and cooperatives are made up of women too. Furthermore, the vast majority of the executive committee members are women and, locally, they are capacitating Female Community Health Volunteers.

One of these women has particularly inspired me. When we went to visit the Baglung district association we talked with the president of caregivers association - she is taking care of a number of family members alone and also doing the activities of association. She spoke of the importance of accessing medicine, whilst receiving proper care,

Due to the disease my family members suffers life-time, but the medicine and proper care make them more fit to perform properly in normal life.

LEADS have initiated the association for caregivers in Nepal. This association is working on advocacy issues to influence policies. Also through the cooperatives is working on fund revolving, which is helpful for income generation among people with mental health issues and their caregivers.

Changing the game in Nepal.

During this eight days exposure visit, we’ve explored enormous knowledge from the working team of Nepal and the culture of Nepalese people.

With limited resource Nepal has done and doing tremendous work on mental health and several organisation of Nepal are considering mental health as important area to work on.