The Bhutanese Leading the way.
A deep-seated issue that remains shrouded in silence is mental health. As the world grapples with the complexities of psychological well-being, many in Bhutan, too, find themselves at a crossroads, where understanding and stigma intersect in the narratives of the people.
Tshering Yangzom, a resident of Tsirang, reflects on her personal encounter with mental health within her family.
She said “Our family dynamic has become tense and more circumspect, as a result of my brother’s occasional emotional outbursts, which are a sharp contrast to his typical behaviour. He had never behaved like that before; it was during his outburst last year that he was willing to hit and fight anyone. We sobbed and consoled him for hours as a result.”
She said that despite the turmoil, the family refrained from seeking professional help, a decision influenced by a lack of awareness and accessible resources in their village.
She said, “I think there is a sheer lack of awareness and understanding of mental health in remote parts, despite living in the 21st century, and our family had no clue to whom to contact during the turmoil we went through last year.”
Ten Dorji, a resident of Thimphu, said, “In our country, mental health issues are prevalent, particularly in urban areas. From my interactions, I have observed that factors, such as financial strain, fractured family dynamics, and intense work pressures contribute significantly. Moreover, alongside the challenges of mental health, itself, there exists a pervasive stigma surrounding individuals who are diagnosed with it.”
“People often overlook those with mental illness, dismissing their behaviours as simply “difficult” or “eccentric.” There’s a tendency to isolate and label individuals who withdraw from social interactions or express unconventional opinions as “crazy” or “unstable.” Which is very wrong,” he added.
He said that once one is diagnosed with a mental illness, it becomes difficult for people to put trust in them.
Dema Lhamo, a recent college graduate, also shared her perspective on the stigma surrounding mental illness.
She said, “There is a pervasive misconception that individuals with mental illness cannot be effectively treated, a belief that unfortunately infuses our society. In Bhutan, mental illness is often referred to as “Sem Kham ghi Nyezhi,” associating it with the soul and suggesting a sense of weakness or psychological instability.”
She said, “This stigma can discourage individuals from seeking help, as being labelled as mentally unstable may lead to social isolation. I had a schoolmate who used to struggle with mental health issues due to her stepfather harassing her. I told her that we should take this issue to our school’s counsellor before anything bad happens to her; however, without her courage, we couldn’t do anything.”
“Now that I think of it, I think I shouldn’t have let it slide easily, but I could have forced her every day to talk with the school counsellor and immediately to the police,” she added.
Dema Lhamo said that she does not know what has happened to her friend or her whereabouts after high school.
Dorji Lhendup, a high school graduate, shared similar sentiments.
He said, “Despite witnessing individuals grappling with psychological distress, I could not do anything as I was hesitant to intervene. Due to societal taboos, such as personality in schools, most people don’t view mental illness as a disease; instead, they believe it is something that people do to get attention. Additionally, people believe that emotional instability is a contributing factor to mental illness, so I feared what if the other person would not like it.”
Kezang Dechen, another high schooler, said that the societal attitudes towards mental illness include ostracization and neglect faced by those seeking help. Which is true for those who were closely associated with the one who sought help.
25-year-old Priya is one of them, as she shares her harrowing experience navigating her nephew’s chronic anxiety disorder, which reveals the painful reality of denial and resistance within families.
She said, “My nephew has been quiet ever since I have known him, all of us thought he just did not like talking too much, and we let him be, but at the beginning of this year, he did not want to go to school and was always cooped up in his room, which made me worry after a repeated pattern for weeks.”
“When I inquired about it consistently, I found out he could not face people, did not like meeting them or talking with them, and at the end, did not like doing anything at all. It was then that I made the decision to take him to a counsellor; it was then that he was diagnosed with chronic anxiety disorder,” she added.
She said that she made it a point to inform her family members about the diagnosis. To her astonishment, nobody could believe it was true; they were all in complete shock.
Another sister also talked about her experience.
“Rehab facilities and mental health wards are stigmatized. My brother’s need to be taken to a rehabilitation facility for treatment had my father in denial and in mourning. More than his son’s health and well-being, his reputation was his first concern,” she said.
“I was completely taken aback by my father’s behaviour, but I realised that everyone reacts this way in our country, so I decided to forgive him, and look after my brother while he was receiving assistance,” she said.
She said that it should not have been the case, and now there are worries about the denial of the family members becoming the new normal when their child or a relative seeks help due to their mental illness.
Ten Dorji also emphasised the urgent need for Bhutan to prioritise mental health advocacy programs and improve counselling facilities, including the establishment of a dedicated psychiatric hospital to ensure comprehensive treatment options for individuals in need.
Furthermore, the investigation revealed a widespread lack of understanding regarding mental health issues among the people. Even among those who were aware, there was a prevailing reluctance to seek assistance when needed, driven by the fear of societal judgement and stigma.
