Rapid spread of COVID-19 infection reached Nepal in about 1 month of its first appearance in China in December 2019 and affected all spheres of life and society including health and education, like in other countries. We are unprepared for this new menace with many unknown facts and uncertainties when well developed set ups with advanced science and technology also seemed drowned. We attempt here to appraise our situation (condition, trend) and reflect on to the lessons (observations, and messages) that we draw in various major areas of the activities of B. P. Koirala Institute of Health Sciences. We become acutely aware about the adverse effects of this pandemic in its academic, service and research activities along with all other aspects. Amidst the challenges, we were forced to take steps in scattered and trial and error pattern. This pandemic has brought our deficiencies in health system into surface and is offering opportunity to review, revise and reform them. We all the stakeholders, i.e. students, patients, clients, teachers, faculties, staff and authorities are in the same boat; all need to be in healthy, balanced and functional state for fruitful travel. We have certain weaknesses, drawbacks, deficits; and some strengths that we now should realize to move ahead in this COVID era.

No abstract

No abstract

 Introduction: Mental disorders are recognized as a major contributor (12%) to the global burden of disease and are among the most stigmatizing conditions worldwide. The lack of awareness is very evident in Nepal. In this study, we aimed to learn about the attitude of senior secondary level students towards mental illness. Material And Method: Descriptive cross-sectional study was conducted amongst senior secondary level students to investigate about their attitude towards mental illness. We recruited a sample of 138 students from classes 11 and 12 from a conveniently sampled school of Dharan Sub-metropolitan. Semi-structured questionnaire was used to elicit the information. Results: Our study group consisted of 53.6% females while 46.4% were males. Equal numbers of students were sampled from each grades with their ages ranging from 14-18 years. The mean for total of BMI scale was 52 and the standard deviation was observed to be 12.810. The T-tests revealed males had more negative attitude than the female students which was statistically significant with a p value of 0.048. Our study revealed that there was a significant negative correlation between the attitude scores and the grade the respondents were studying and also between the gender of the respondent, father’s and mother’s education level and in students having a family member or neighbor suffer from mental illness. Conclusion: Most of the students in the senior secondary level were found to have negative attitudes towards mental illness though no any variables were found to be contributing towards such perceptions from our research.

Background Pathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes. Methods This was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed. Results Most of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt. Conclusions Faith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.