Mental health care in Nepal: current situation and challenges for development of a district mental health care plan

Simple item page
dc.contributor.authorLuitel, Nagendra P
dc.contributor.authorJordans, Mark J
dc.contributor.authorAdhikari, Anup
dc.contributor.authorUpadhaya, Nawaraj
dc.contributor.authorHanlon, Charlotte
dc.contributor.authorLund, Crick
dc.contributor.authorKomproe, Ivan H
dc.date.accessioned2015-06-30T12:12:07Z
dc.date.available2015-06-30T12:12:07Z
dc.date.issued2015-02-06
dc.date.updated2015-02-16T19:02:07Z
dc.description.abstractAbstract Background Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. Method A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Results Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry of Health and Population (MoHP). Strategies to overcome these challenges included involvement of MoHP in the process, especially by providing psychotropic medicines and appointing a senior level officer to facilitate project activities, and collaboration with National Health Training Centers (NHTC) in training programs. Conclusions This study describes many challenges facing mental health care in Nepal. Most of these challenges are not new, yet this study contributes to our understanding of these difficulties by outlining the national and district level factors that have a direct influence on the development of a district level mental health care plan.
dc.identifier.apacitationLuitel, N. P., Jordans, M. J., Adhikari, A., Upadhaya, N., Hanlon, C., Lund, C., & Komproe, I. H. (2015). Mental health care in Nepal: current situation and challenges for development of a district mental health care plan. <i>Conflict and Health</i>, http://hdl.handle.net/11427/13194en_ZA
dc.identifier.chicagocitationLuitel, Nagendra P, Mark J Jordans, Anup Adhikari, Nawaraj Upadhaya, Charlotte Hanlon, Crick Lund, and Ivan H Komproe "Mental health care in Nepal: current situation and challenges for development of a district mental health care plan." <i>Conflict and Health</i> (2015) http://hdl.handle.net/11427/13194en_ZA
dc.identifier.citationLuitel, N. P., Jordans, M. J., Adhikari, A., Upadhaya, N., Hanlon, C., Lund, C., & Komproe, I. H. (2015). Mental health care in Nepal: current situation and challenges for development of a district mental health care plan. Conflict and health, 9(1), 3.
dc.identifier.ris TY - Journal Article AU - Luitel, Nagendra P AU - Jordans, Mark J AU - Adhikari, Anup AU - Upadhaya, Nawaraj AU - Hanlon, Charlotte AU - Lund, Crick AU - Komproe, Ivan H AB - Abstract Background Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. Method A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Results Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry of Health and Population (MoHP). Strategies to overcome these challenges included involvement of MoHP in the process, especially by providing psychotropic medicines and appointing a senior level officer to facilitate project activities, and collaboration with National Health Training Centers (NHTC) in training programs. Conclusions This study describes many challenges facing mental health care in Nepal. Most of these challenges are not new, yet this study contributes to our understanding of these difficulties by outlining the national and district level factors that have a direct influence on the development of a district level mental health care plan. DA - 2015-02-06 DB - OpenUCT DO - 10.1186/s13031-014-0030-5 DP - University of Cape Town J1 - Conflict and Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Mental health care in Nepal: current situation and challenges for development of a district mental health care plan TI - Mental health care in Nepal: current situation and challenges for development of a district mental health care plan UR - http://hdl.handle.net/11427/13194 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/13194
dc.identifier.urihttp://dx.doi.org/10.1186/s13031-014-0030-5
dc.identifier.vancouvercitationLuitel NP, Jordans MJ, Adhikari A, Upadhaya N, Hanlon C, Lund C, et al. Mental health care in Nepal: current situation and challenges for development of a district mental health care plan. Conflict and Health. 2015; http://hdl.handle.net/11427/13194.en_ZA
dc.language.rfc3066en
dc.publisher.departmentCentre for Public Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License*
dc.rights.holderLuitel et al.; licensee BioMed Central.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0*
dc.sourceConflict and Healthen_ZA
dc.source.urihttp://www.conflictandhealth.com
dc.subject.otherMental healthen_ZA
dc.subject.otherSituation analysisen_ZA
dc.subject.otherIntegration of mental health into PHCen_ZA
dc.subject.otherMental health care planen_ZA
dc.subject.otherNepalen_ZA
dc.titleMental health care in Nepal: current situation and challenges for development of a district mental health care plan
dc.typeJournal Articleen_ZA
uct.type.filetype
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Luitel_Mental_health_care_in_Nepal_2015.pdf
Size:
394.38 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.72 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Journal Articles