Assessment of community needs and perception of mental health in rural Nepal

Abstract

Background: Mental health disorders are a major global burden, with countries like Nepal experiencing high prevalence and significant treatment gaps. Community perceptions critically shape health-seeking behaviours, yet research in rural Nepal is limited. This study explores knowledge, perceived risk factors, care options and help-seeking attitudes related to mental illness and suicide in Saudiyar, a rural village in Dang district, Nepal, with no regular formal mental health services. It is part of a needs assessment by Health Foundation Nepal (HFN) to inform planning of community mental health interventions. Methods: This cross-sectional study was conducted in 2018 in Saudiyar, Dang. Using purposive and convenience sampling, 119 participants from 11 community groups were surveyed with a semi-structured Nepali-language questionnaire. Topics included mental health knowledge, perceptions, risk factors, suicide exposure and care preferences. Complete case analysis and descriptive statistics were used to summarise findings using the Statistical Package for the Social Sciences (SPSS) Results: A total of 95.8% of participants had heard of mental illness, with the radio as the main source of information. Stress and worry (57.1%), alcoholism (53.8%), and depression (28.6%) were identified as key mental health issues. Low self-esteem, poverty, and family problems were seen as major risk factors for mental illness and suicide. While 38.2% had known someone who died by suicide, only 4.5% reported personal experience with mental illness, and 10.2% reported a family member being affected. Doctors (75.7%) and medication (88.8%) were seen as helpful treatments, alongside yoga (78.2%) and Bhajan (religious songs – 59.7%). Nearly all participants (99.2%) supported establishing community-based mental health services. Conclusion: TOur study identified a community’s perception of stress, alcohol use, poverty-related hardship, family conflict and low self-esteem as major contributing factors for mental illnesses and suicide. While biomedical treatment was widely valued, most participants found religious and spiritual practices helpful for mental health.