Paudel Shishir, Chalise Anisha, Khatri Dhurba, Poudel Sujan, Khanal Aagya
Kathmandu Institute of Child Health, Hepaliheight, Kathmandu, Nepal.
Center for Research on Environment, Health and Population Activities (CREHPA), Lalitpur, Nepal.
Lancet Reg Health Southeast Asia. 2025 Apr 30;36:100588. doi: 10.1016/j.lansea.2025.100588. eCollection 2025 May.
This study evaluates Nepal's mental health system through the World Health Organization's six building blocks: governance, financing, workforce, service delivery, essential medicines, and information systems. Despite policy advances toward integrating mental health services within primary care, significant challenges persist, including governance fragmentation, workforce shortages, insufficient funding, inconsistent availability of essential psychotropic medications, and a weak health information infrastructure. Federalization has introduced both opportunities and challenges for mental health governance across the different tiers of government. Stigma, resource constraints, and limited coordination further hinder service accessibility. This study identifies actionable priorities, including strengthening workforce capacity, expanding community-based services, enhancing inter-sectoral collaboration, and improving access to essential medicines. Addressing these issues through targeted policies and increased funding is crucial to build a more equitable and effective mental health system in Nepal, capable of addressing the rising burden of mental health disorders.
治理、融资、劳动力、服务提供、基本药物和信息系统。尽管在将心理健康服务纳入初级保健方面政策取得了进展，但重大挑战依然存在，包括治理分散、劳动力短缺、资金不足、基本精神药物供应不一致以及卫生信息基础设施薄弱。联邦制给不同层级政府的心理健康治理带来了机遇和挑战。耻辱感、资源限制和有限的协调进一步阻碍了服务的可及性。本研究确定了可采取行动的优先事项，包括加强劳动力能力、扩大社区服务、加强部门间合作以及改善基本药物的获取。通过有针对性的政策和增加资金来解决这些问题对于在尼泊尔建立一个更公平、更有效的心理健康系统至关重要，该系统能够应对不断上升的心理健康障碍负担。
