However, mental health is yet to get the desired budget or attention
Bhutan’s only practicing psychiatrist, Dr. Damber Kumar Nirola, sees between 25-30 patients daily at the Jigme Dorji Wangchuck National Referral Hospital. There are at least four youth any given day in that group.
Most youth suffer from anxiety caused by academic-related stress, and family issues.
Dr. Nirola shares that the emergency room at JDWNRH sees attempted suicide cases by youth almost every other day. Sixty-eight deaths by suicide have been recorded so far this year of which six are youth below 25 years.
Literature on youth and mental health is almost non-existent. The Department of Youth and Sports with the help of Dr. Nirola made an attempt to develop this literature through a survey on youth and mental health this month. The survey had less than 200 respondents and covered only certain parts of Thimphu, but manages to provide some insight on the mental health problems of young Bhutanese. The survey found that 30 respondents have attempted to kill themselves, 35 have had problems with gambling, and 105 have consumed alcohol with more than half of them being regular drinkers. But only 37 respondents have ever talked to a psychiatrist. Although the survey has its limitations, the data evinces the need for urgent attention on the mental health of youth.
The psychiatric department at the JDWNRH is, however, stretched beyond its capacity. Besides Dr. Nirola, the department has an American psychologist for a period of three months at a time through the Health Volunteers Overseas programme and since October 2013, there have been two Cuban psychologists based in Monggar and Gelephu. Patients are, however, known to have encountered communication problems with foreign doctors.
The dismal state of affairs at the psychiatric department is not a new story. Things have not changed for the better over the years. The first psychiatrist joined the JDWNRH in 1999 but a separate psychiatric ward was created only in 2004. The first psychiatrist is, currently, on extended leave. The ward has not seen a single trained counselor till date. A programme for clinical or basic counseling is being developed to address this but is expected to take some time.
Although there has been scholarship offered for psychiatry, there have been no takers. Dr. Nirola explains that the lack of interest could be caused mainly by psychiatry not being considered a “real medical job” and the negative labeling of doctors like him as “mental/ psycho doctors”.
The stigmatization is not limited to the profession. There continues to be a great deal of stigma attached to mental health as well. “People get offended when they are referred to a psychiatrist…No one wants to be thought of as being mad or psycho.” Dr. Nirola admits that the government and the media are doing their bit to increase awareness on mental health, but insists so much more needs to be done. “We have to try and meet people in person to dispel misconceptions and alleviate the stigma attached to mental health issues.”
A major chunk of the annual public health budget is earmarked for communicable and non-communicable diseases (lifestyle-related) by the Department of Public Health. This year, the two combined have a budget of approximately Nu. 86 million.
The government has allocated Nu. 2million for mental health for 2014-2015, a million more since the last fiscal year. Together with donor funds, the total budget for mental health amounts to Nu. 5million.
One of the recommendations of the DYS survey is, “adequate public education on mental health and mental health issues to promote easy access to professional services” for youth. The professional services are unfortunately inadequate.
Contributed by : Namgay Zam (The writer is a free lance journalist and Radio talk show host. )