This paper describes the current state of mental health services in Nepal and reflects on the significant changes over the past decade. The main challenges to overcome are proper implementation of community-based services, the high suicide rate, stigma of mental illness, financial constraints, lack of mental health legislation and proper utilisation of human resources.

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Although training in psychotherapy is an integral part of psychiatry training, standards in psychotherapy training have wide variation across and within countries. Post-graduate psychiatry training has been conducted in Nepal for over two decades, but little is known about its psychotherapy training provisions. An online survey was conducted with early career psychiatrists in Nepal. The findings show that the majority recognised psychotherapy training as important and were eager to pursue further training. However, two-thirds had no access to psychotherapy training opportunities. These results highlight the need to improve access to training in different psychotherapy modalities in Nepal.

Introduction: Training, practice and continuing professional development in neuropsychiatry and clinical neuroscience vary across different countries. However, little is known about the opinions of the Nepalese psychiatrists about the provision of neuropsychiatry training. This study evaluates the current training in neuropsychiatry and clinical neurosciences during the postgraduate psychiatry training and reflect on current practice. Material And Method: The participants were psychiatrists (qualified and psychiatry residents). An online questionnaire using Survey Monkey electronic Platform was emailed with a uniform resource locator (URL). Results: Sixty-four out of ninety-five participants responded with response rate of 65.3%. Two-third of the respondents were qualified psychiatrists. The duration of neurology rotation ranged from 1 to 3 months and it was reported to be mandatory. Two-thirds reported that there is no clinical neuropsychiatry training during psychiatry residency. On a ten-point Likert scale (with 10 being the highest possible score), the participants rated their neuropsychiatry training as 5.16±1.84 while they rated the necessity for further training in neuropsychiatry as 7.92±1.96. Two-thirds identified a lack of interest by the specialty society as an obstacle for the implementation of neuropsychiatry training for psychiatrists. More than half viewed that neuropsychiatry training to be incorporated into the existing psychiatry training scheme whereas three-fifths favoured a one-year specific training program in neuropsychiatry after completion of psychiatry training. Conclusion: The current psychiatry training is inadequate to meet substantial neuropsychiatry training opportunities for a high proportion of psychiatrists in Nepal. This finding may be used to improve and standardize neuropsychiatry training in postgraduate psychiatry training.

Background Nepal is a developing low-income country in Southeast Asia. There is a huge burden of child and adolescent mental health (CAMH) in Nepal which has a population of around 29 million and 40–50% of the population comprises of children and adolescents. Child and Adolescent Psychiatry (CAP) has not been formally recognized as a subspecialty in Nepal and there is no standardized curriculum for CAP training. The objectives of the survey were to identify the current status of training, shortfalls and to explore the training experiences of early career psychiatrists (ECPs) in Nepal. Methods The participants were ECPs in Nepal. An online questionnaire was created consisting of 20 questions including 3 questions requiring an answer indicating a level of agreement scored on a ten-point scale. Questionnaire using google form was e-mailed with the uniform resource locator (URL). Respondents anonymously answered the questions. The survey was open from 01/01/2019 to 01/04/2019. Results Response rate was 83.69%. Around 42% (n = 32) were trainees in Doctor of Medicine (MD) Psychiatry and 58% (n = 45) of respondents had completed their MD Psychiatry. More than half of the ECPs had not received formal training specific to CAP. Seventy percent (n = 54) ECPs reported that their current workplace did not have a specific unit to address psychological problems in children and adolescents. However, 62% (n = 48) of ECPs came across 10 CAP cases per week. On a ten-point scale, mean score of ECPs confidence in diagnosing, management and overall confidence in CAP cases were 5.18 ± 1.56, 4.58 ± 1.59 and 4.67 ± 1.62 respectively. Fifty-four percent (n = 42) of respondents rated their training as limited and 74% (n = 57) of them wanted additional training in CAP. Psychological intervention, psychotherapy and a fellowship course were the additional training most of the ECPs wanted to receive. Conclusion Despite significant exposure to CAP patients in daily practice, ECPs self-evaluated their training as inadequate and there is no standardized CAP training program in Nepal for ECPs. The desire of ECPs to receive additional training in CAP is highly encouraging and positive. We advocate for the development and incorporation of CAP training in current psychiatry training to fulfill these unmet training needs in Nepal.