All Professional Bodies, National Associations (e.g. Mental Health, School, Guidance, Addiction, Faith-based etc.) and Accrediting Organisations.
Universities and Other Education and Training Institutes
Counselling Agencies, Services, Group Practices, Counselling Centres
Background & Context
According to the World Health Organization (2014), the age-standardized suicide rate for Nepal revealed that the country ranks at number seven in the world (at 24.9 suicides per 100,000 population). In addition to that, another assessment conducted on the mental state of the 2015 earthquake survivors showed that there was a 10.9% increase in suicide ideation post-earthquake and an overall increase in suicide rates (International Medical Corps, 2016). Despite having a significant mental health problem, there are many gaps in research when it comes to the country’s overall mental health. Additionally, “Nepal does not have reliable data related to suicide and attempted suicide” (Marahatta et.al, 2017, p. 2?).
Professional counselling seems to be an underplayed and underrated profession in the country. According to Luitel et al. (2015), there is a median number of 0.05 for every 100,000 people regarding the ratio of psychiatrists to the low- and middle-income countries, which includes Nepal.
Current Regulatory Status / Level of Recognition:
There is not any up to date information available on the status of counsellors and their practices in Nepal. In terms of availability, the Centre for Mental Health and Counselling (CMC-N) seems to be the most widespread form of mental and psychosocial support in the country. They seem to also be the only organization that provides training for mental health workers that comprises a six-month training course. Although being a non-governmental organization (NGO), CMC-N works at a community level in a close collaboration with the government and other NGOs.
As for known associations that are present in Nepal, the Association for the Protection of Children Nepal (APC-N) seems to be the only active association that is related to counselling services. Based off of this information, rescuing children and the rehabilitation as well as counselling these children seems to be the primary field of counselling in Kathmandu. Established in 2003, the APC-N seeks to rescue children and provide them various shelters with proper living conditions along with opportunities to learn and develop. It is also worth noting that they provide a variety of therapies and modalities including, but not limited to: Cognitive Behavioral Therapy, Dance Therapy, and Meditation. They are currently caring and supporting more than 300 children through their program.
As mentioned earlier, there is a disproportionate distribution between mental health resources and the citizens of Nepal. Most of the available resources seem to only be concentrated in the main city of Kathmandu. Since more information is available on the APC-N and CMC-N, counselling practices/settings in that aspect is conducted across locations such as:
- Mental health centers
- Intervention programs in schools
Challenges & Trends
Emerging from a decade long civil war that claimed the lives of more than 16,000 people, Nepal’s healthcare system has gone through quite the turmoil. During the Maovadi dwandakaal (period of insurgency), “health staffs were intimidated and tortured by both the government forces and insurgents” (Luitel et.al, 2015, p. 2). With such a shaky start to its mental healthcare development, it is no mystery that Nepal is in dire need of a well-planned mental health policy. According to Upadhaya et al. (2017), a mental health policy was formulated back in 1996; however, it was never implemented despite a fourth revision of the draft. Besides that, other factors that contributed to a poor mental health care system includes but not limited to inadequate mental health care human resources, inequitable allocation of budget to mental health care, inadequate supply of psychotropic drugs, and insufficient infrastructure for delivery of mental health and psychosocial services.
Additional Information & References
For a deeper exploration of the counselling profession in the country, interested readers are recommended to read the following journal & website articles:
- International Medical Corps. (2016). Exploring the mental health and psychosocial support needs and resources among earthquake-affected communities in Nepal (1). https://internationalmedicalcorps.org/wp-content/uploads/2017/07/International-Medical-Corps-2016-Nepal-Summary-Report.pdf
- Lamsal, P. L., & Gautam, R. G. (2018, July 17). Mental health in Nepal: Time to invest more on the sector. https://www.mhinnovation.net/blog/2018/jul/11/mental-health-nepal-time-invest-more-sector
- Luitel, N. P., Jordans, M. J., Adhikari, A., Upadhaya, N., Hanlon, C., Lund, C., & Komproe, I. 4. (2015). Mental health care in Nepal: current situation and challenges for development of a district mental health care plan. Conflict and Health, 9(1), 1–4. https://doi.org/10.1186/s13031-014-0030-5
- Marahatta, K., Samuel, R., Sharma, P., Dixit, L., & Shrestha, B. (2017). Suicide burden and prevention in Nepal: The need for a national strategy. WHO South-East Asia Journal of Public Health, 6(1), 45. https://doi.org/10.4103/2224-3151.206164
- Upadhaya, N., Jordans, M.J.D., Pokhrel, R., Gurung, D., Adhikari, R.P., Petersen, I., Komproe, I.H. (2017). Current situations and future directions for mental health system governance in Nepal: findings from a qualitative study. International Journal of Mental Health Systems, 11, 37. https://doi.org/10.1186/s13033-017-0145-3
- World Health Organization. (2014). Preventing suicide: a global imperative (1). https://apps.who.int/iris/bitstream/handle/10665/131056/9789241564779_eng.pdf;jsessionid=9C3F091377B66BE6CB5B3FF472AD3243?sequence=1