20 YEARS AGO THIS WEEK

It’s all in the mind

We have come a long way in how we manage patients with psychological disorders. It might shock many to know that two decades ago mentally ill people could legally be jailed in Nepal.

We now have better treatment facilities, awareness and investment but increasingly more people are suffering from psychological disorders, particularly in urban centres during the pandemic. There were 7,141 reported deaths due to suicides nationwide in the past 12 months, up from 6,252 the year before. There is a direct correlation between lockdowns and a spike in mental health problems.

Psychiatrists have also reported increased cases of anxiety, depression, PTSD, hypochondria, obsessive disorders and psychotic symptoms, and recent studies have found that as high as one-third of Nepal’s population have some form of psychological disorders.

Experts from the report 20 years ago this week from issue #56 17-23 August 2001:

Instead of ensuring the human rights of the ill and their right to treatment, existing laws legitimate inhuman treatment. Local administration laws grant chief district officers (CDO) the right to put mentally ill people into jail for their own safety or for the safety of the community upon the recommendation of a doctor. But CDOs are not given a concomitant responsibility to protect the rights of disturbed people. And there is no legal provision to reverse this “mentally sick” certification, even if the person’s condition improves. 

A person’s mental health is mainly determined by genetics, environment (like family and work atmosphere), and individual factors like susceptibility to tension or depression. Everyone has their own breaking point, and when this point is reached, a person develops a mental disturbance. 

There is no official study on prevalence, but researchers estimate that about 12 percent of Nepalis suffer from some form or degree of mental illness at any given time, and at least two percent suffer from severe but treatable mental illness. Even the presence of four million suffering people has failed to instil a sense of urgency among policymakers and public health officials. Though a National Mental Health Policy was announced in 1997, the issue is still treated as separate from other human development endeavours. Only 0.14 percent of the national health budget was allocated to mental health programmes in fiscal 2000. 

The general perception about mental sickness is perhaps reflected in the policies. Here too, the issue remains a taboo subject, and the ailment, one that only affects “the poor, uneducated, underprivileged and downtrodden.” But researchers the world over have been saying for some time now that the prevalence rate for mental illness is similar everywhere-in developed and under-developed countries, in cities and in villages. The difference lies on the types of disorders, which often depends on the environment the patients work and live in. 

From archives material of Nepali Times of the past 20 years, site search: www.nepalitimes.com

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