National 7 (Spotlight Weekly)

Growing Despondency

The insurgency is fueling the number of mental patients, which has grown considerably in the last couple of years

By DEWAN RAI

Patan Mental Hospital, the one and only mental hospital in the country bears a big burden of mental patients. With its paltry strength of service with 29 beds and four psychiatrists, the hospital is feeling the heat due to rising number of patients particularly over the last couple years. The hospital examines 50 to 60 outdoor patients everyday.

In the year 2001/02, the hospital treated 17,627 cases out of which 3,520 were new. The number is dramatically high from 13,884 cases the hospital treated in the year 2000/01. In the early nineties, the hospital used to treat around 8 to 9 thousand of patients.

Teaching hospital : Increasing cases of mental diseases

The Department of Psychiatry, Tribhuwan University (TU) Institute of Medicine (popularly known as Teaching Hospital) has the same story to tell. “We check up 40 to 50 outdoor patient everyday of which includes 15 to 20 new cases,” said Dr. Bidhya Dev Sharma, Associate Professor of the department.

The number of outdoor patients is increasing every year. One of the main reasons in the upsurge of mental cases is the growing insurgency and the resulting violence, killing and destruction in the country.

In the conflict between the Maoists and the government, more than 8,000 people have already died and countless others have been injured. Many parents lost their sons and daughters. Thousands of children have become orphan. Many lost their relatives and friends. Tens of thousands of people were displaced from their native. While their physical state is apparent, their mental situation, too, has degenerated. The depression and anger the people feel due to violence has triggered the mental diseases.

According to Dr. Sharma, the number of patients who visited the psychiatry department during the period of imposition of state of emergency was considerably high in Teaching Hospital. “When the armed soldiers started marching freely on the streets of Kathmandu, the scene they had never seen before, it created fear among ordinary people resulting in various forms of mental diseases,” he elaborated.

Conflict inflicted people suffer from post-traumatic stress disorder. Loss of appetite, insomnia, phobia, lack of concentration, loss of desire to work, mental debility are the symptoms of the PTSD. PTSD syndrome leads to anxiety, depression, mania and even psychosis, which seriously impair their health.

“When the Maoists embarked on bloodshed, it created dreadful environment everywhere. They threatened people to death, extorted money from them. They robbed in broad daylight. People were compelled to support them either physically or morally. When they did, the state would retaliate against them. How could they live calmly without suffering any kind of fear is such situation?,” said Dr. Dhruba Man Shrestha, director of Patan Mental Hospital.

Patan Mental Hospital had handled 6,000 cases in OPD service in 1985 whereas the number reached about 18,000 by the year 2001. This shows the number of patients had increased by 3 folds within one and a half decade period. The hospital had looked after 2,500 new cases in 1996 when the Maoists started their underground movement. Later in 2001 the number increased as much as 3,500.

The hospital, however, has not maintained separate file about mental patients who were victims of conflict. Besides, the growth in population also has fueled the growth in number of patients. “Naturally, when the population increases there will be many cases,” said Dr. Dhruba Man Shrestha. “But there were some cases of PTSD but we have not kept separate record of such cases.”

Another reason for the increase in number of mental patients could be the awareness. Mental diseases are often linked to insanity in our society. It is still considered as social stigma. Therefore, people do not want to go for mental treatment for the fear of being labeled as ‘mad’. “But only 1 to 2 percent of the mental patients are of these type,” said Dr. Sharma.

Fortunately, people do not hesitate to go to Teaching Hospital since it is not known as mental hospital. It is more convenient for the patients to go to the hospital and seek help from the psychiatric department. Many people do not even know that the hospital has this kind of service. It has 22 beds service and 4 psychiatrists are working there. There are hardly 30 psychiatrists in Nepal so far.

Research conducted by experts in various countries have concluded that 10 percent of the total population suffers from any of the minor to major mental diseases.