A World Health Organization survey published in October 2020 found that the coronavirus pandemic (COVID-19) pandemic has disrupted or halted critical mental health services in 93 percent of countries worldwide and that the demand for mental health services is increasing. The survey highlights how COVID-19 has hindered people’s access to mental health services in Nepal and discusses the urgent need for more attention and funding to address this problem. During the first wave of COVID-19 and its resulting lockdown in Nepal, deaths from suicide increased by 11.2 percent between March/April 2020 to June/July 2020 in comparison to suicide deaths during the timeframe in previous years.
During the 11th Gender in Humanitarian Action Task Team (GiHA TT) meeting chaired by UN Women in September 2020, civil society organizations (CSOs), United Nations (UN) agencies, and the Government of Nepal (GoN) highlighted how the COVID-19 pandemic has triggered a focus on mental health crisis in Nepal. This Gender Equality Update focuses on the challenges in providing mental healthcare in Nepal, the innovations made to ensure mental healthcare services reach the most affected communities, and long-term recommendations to sustain mental wellbeing among vulnerable groups.
What are the key gaps in Nepal’s mental healthcare system?
ACCESS TO SERVICES:
In-person counseling and regular follow-up services have been limited during the COVID-19 crisis. Fear of contracting COVID-19 often prevents people in need of support from visiting medical facilities. Natural disasters in addition to COVID-19 – such as floods and landslides – have made it even more difficult for people to contact healthcare providers for psychosocial support.
Nepal – a country with a population of 28 million people – has around one hundred psychiatrists in total. An extremely small percentage of those psychiatrists work in rural areas, where more than 80 percent of Nepal’s population resides. At rural health posts, counselors who have limited training and gender sensitivity are often the only medical staff providing counseling.
PROVISION OF QUARANTINE CENTERS:
Countrywide precautions adopted to prevent the spread of COVID-19, like requiring prospective patients take a molecular PCR COVID-19 test prior to enrolling, have often prevented people from receiving immediate mental health services. In addition to this barrier, there was also a lack of adequate quarantine centers where patients with severe mental health conditions could quarantine for the mandatory 10 days prior to receiving healthcare services. Unlike the pre-COVID-19 context, organizations were unable to bring in patients with severe mental health conditions, like those living on the streets, or accept referrals of mental health patients. As a result, they supported fewer patients than usual.