Mental health law in Nepal

Singh, Rakesh; Khadka, Seema

doi:10.1192/bji.2021.52

Cited by 7 publications

(3 citation statements)

References 6 publications

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“…In 2017, a government mental health policy was drafted, building on the first such policy from 1996. However, the implementation of this policy is pending, awaiting cabinet approval ( Singh and Khadka, 2022 ). To bridge this gap and provide a strategic and clear action for addressing challenges in mental health sector, the National Mental Health Strategy and Action Plan (2020) outlines Nepal’s approach to mental health care.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Nepalese health system’s readiness to manage gender-based violence and deliver psychosocial counselling

Deuba,

Shrestha,

Koju

et al. 2024

Health Policy and Planning

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Violence against women (VAW), particularly intimate partner violence (IPV) or domestic violence, is a major public health issue, garnering more attention globally post-COVID-19 lockdowns. Health providers often represent the first point of contact for IPV victims. Thus, health systems and health providers must be equipped to address survivors’ physical, sexual, and mental healthcare needs. However, there is a notable lack of evidence regarding such readiness in Nepal. This study, utilizing a concurrent triangulation design, evaluated the readiness of public health facilities in Nepal’s Madhesh Province in managing VAW, focusing on providers’ motivation to offer psychosocial counselling to survivors. A cross-sectional study was conducted across 11 hospitals and 17 primary health care centres, where 46 health care providers were interviewed in February-April 2022. The study employed the WHO’s tools for policy readiness and the Physician Readiness to Manage IPV Survey for data collection. Quantitative and qualitative data were collected via face-to-face interviews and analysed using descriptive and content analysis, respectively. Only around 28% of health facilities had trained their staff in the management of VAW. Two out of 11 hospitals had a psychiatrist, and a psychosocial counsellor was available in four hospitals and two out of 17 primary health care centres. Two-thirds of all health facilities had designated rooms for physical examinations, but only a minority had separate rooms for counselling. Though a few health facilities had guidelines for violence management, the implementation of these guidelines and the referral networks were notably weak. Hospitals with One-stop Crisis Management Centres demonstrated readiness in VAW management. Health providers acknowledged the burden of IPV or domestic violence and expressed motivation to deliver psychosocial counselling, but many had limited knowledge. This barrier can only be resolved through appropriate training and investment in violence management skills at all tiers of the health system.

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Section: Introductionmentioning

confidence: 99%

Assessing the Nepalese health system’s readiness to manage gender-based violence and deliver psychosocial counselling

Deuba,

Shrestha,

Koju

et al. 2024

Health Policy and Planning

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“…As the rate of institutional births in Nepal increases [ 43 ], it can be assumed that the likelihood of women experiencing mistreatment during childbirth will also rise. Furthermore, national mental health policies in Nepal focus on reducing major depressive disorders in adolescents and the female population in general [ 52 ], while depressive symptoms in postpartum women receive less attention, despite their high prevalence of suicidal ideation [ 10 , 53 ]. Due to limited evidence of the adverse maternal health outcomes associated with mistreatment during institutional childbirth in Nepal, it is timely to investigate these issues.…”

Section: Introductionmentioning

confidence: 99%

Does mistreatment during institutional childbirth increase the likelihood of experiencing postpartum depressive symptoms? A prospective cohort study in Nepal

Gurung,

Bask

2024

Global Health Action

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Background Postpartum depression is associated with low socioeconomic status, adverse birthing processes, and life stress. Increasing evidence of mistreatment during childbirth, negative birth experiences, and poor quality of maternal care is of global concern. Objective To assess the risk of experiencing depressive symptoms among postpartum women exposed to mistreatment during institutional birthing in Nepal. Method We conducted a prospective cohort study from 29 March to 19 August 2022. Of 1629 women who gave birth in a hospital in Nepal, 1222 were assessed for mistreatment during childbirth and depressive symptoms using the Edinburgh Postnatal Depression Scale. We used binomial generalized linear mixed model to examine the risk ratio of postpartum depressive symptoms in women exposed to mistreatment during childbirth. Results The prevalence of postpartum depressive symptoms was 4.4%. Women exposed to mistreatment during childbirth were almost fifty percent more likely to have postpartum depressive symptoms (cRR 1.47; 95% CI 1.14, 1.89; p = 0.003) compared with the unexposed group. Furthermore, adolescent mothers exposed to mistreatment during childbirth had a seventy percent increased risk of depressive symptoms (aRR 1.72; 95% CI 1.23, 2.41; p = 0.002 ). Similarly, women who gave birth to female infants were thirty percent more likely to experience postpartum depressive symptoms (aRR 1.32; 95% CI 1.01–1.74; p = 0.039 ). Conclusion We observed an association between postpartum depressive symptoms and mistreatment during institutional births in Nepal. The implementation of appropriate respectful maternity care during childbirth and also routine screening for depressive symptoms is critical to improving perinatal mental health and well-being.

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“…Since the 1990s, Nepal has seen changes in the mental health policy landscape. Amidst political and environmental disasters, the mental health sector has undergone reforms (Singh and Khadka, 2022 ). The first national mental health policy was formed in 1996; however, its status of implementation was questionable.…”

Section: Introductionmentioning

confidence: 99%

Mental health–related structural stigma and discrimination in health and social policies in Nepal: A scoping review and synthesis

Gurung,

Neupane,

Bhattarai

et al. 2023

Epidemiol Psychiatr Sci

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Aims National policies can be used to reveal structural stigma and discrimination in relation to mental health. This review assesses how structural stigma and discrimination are manifested in the policies and legislations of Government of Nepal. Methods Scoping review methodology was followed to review policy documents (acts of parliament, legislation, policies, strategies, guidelines and official directives) drafted or amended after 2010. Results Eighty-nine policies were identified related to health, social welfare, development and regulations which were relevant to people with psychosocial and mental disabilities or have addressed the mental health agendas. Several critical policy failings and gaps are revealed, such as the use of stigmatizing language (e.g., ‘insane’ or ‘lunatic’), inconsistencies within and between policies, deviation from international protocols defining legal capacity and consent, lack of inclusion of the mental health agenda in larger development policies and lack of cost-effective interventions and identification of financing mechanisms. Provisions for people living with mental health conditions included adequate standard of living; attaining standard mental health; the right to exercise legal capacity, liberty and security; freedom from torture or discrimination; and right to live independently. However, other policies contradicted these rights, such as prohibiting marriage, candidacy for and retention of positions of authority and vulnerability to imprisonment. Conclusion Mental health–related structural stigma and discrimination in Nepal can be identified through the use of discriminator language and provisions in the policies. The structural stigma and discrimination may be addressed through revision of the discriminating policies, integrating the mental health agenda into larger national and provincial policies, and streamlining policies to comply with national and international protocols.

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Mental health law in Nepal

Cited by 7 publications

References 6 publications

Assessing the Nepalese health system’s readiness to manage gender-based violence and deliver psychosocial counselling

Assessing the Nepalese health system’s readiness to manage gender-based violence and deliver psychosocial counselling

Does mistreatment during institutional childbirth increase the likelihood of experiencing postpartum depressive symptoms? A prospective cohort study in Nepal

Mental health–related structural stigma and discrimination in health and social policies in Nepal: A scoping review and synthesis

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