A new dawn
The availability of dedicated child and adolescent mental health services helps a grandmother in Nepal’s west find much-needed hope and support for her young grandchild
Surkhet, Nepal: “She would just wander off by herself, and we would have to go, sometimes even late at night, to look for her and bring her back home.”
Mangali, from Surkhet District in western Nepal, is reflecting on the challenges she has faced in raising her granddaughter.
The 57-year-old had always been close with her grandchild, but even more so after both of the young girl’s parents migrated to India to seek better work opportunities, making Mangali the primary caregiver. This was not always easy, Mangali says, given that her granddaughter was prone to impulsive behavior and erratic movements that made it difficult for her to navigate the world around her.
“If she went out to play for a bit, she would often get hurt and rush back,” she explains. “Or she would just sit down in a random place and would not be able to get up.”
Mangali found herself on constant alert, endlessly worried for her granddaughter’s safety and well-being.
UNICEF Nepal/2024/MMalla
“It was quite a struggle.”
One day, while selling roasted corn on the pavement outside the Provincial Hospital, Mangali met a healthworker who noticed her granddaughter sitting next to her in a state of distress. Inquiring about the girl's condition, the healthworker had encouraged Mangali to seek help at the hospital. Here, they were able to initiate immediate treatment for the young girl.
This was possible thanks to a child and adolescent mental health facility established at the hospital by UNICEF through generous support from Rettig. This facility, equipped for both direct outpatient and tele-mental health services, represents a crucial step in making mental healthcare more accessible to children and families
At the facility, Mangali and her granddaughter were guided by both in-house doctors as well as specialists at Kanti Children's Hospital in Kathmandu, whom they consulted via tele-conferencing. In this way, the doctors were able to provide guidance not only on medication for the child but also on practical ways that Mangali could support her granddaughter’s recovery.
“They advised me to be patient and to slowly teach her basic things, to occupy her with small chores around the house, like chopping vegetables and washing clothes,” Mangali shares. “It felt good to hear their suggestions; they gave me a lot of ideas that I still follow to this day.”
Dr. Sushil Samadarshi, a consultant psychiatrist at the Provincial Hospital, highlights the broader context of mental health issues among adolescents in the region.
“The most common conditions here are panic and depression,” he notes. “Because of the stigma and discrimination associated with mental illness, most children are unable to understand what they are going through, and the lack of awareness among caregivers means these cases often go unaddressed.”
With the establishment of the mental health facility at the Provincial Hospital, children and families who once had limited access to specialized services now have a vital resource.
Dr. Samadarshi explains how the team at the hospital do their best to diagnose and treat cases themselves, but in case of any diagnostic dilemmas or need of further guidance, the availability of the tele-conferencing service is major support.
“The tele-mental health consultation facility is enormously helpful in the diagnosis, management and overall rehabilitation process,” he says. “It has made things very easy and been beneficial to us.”
For Mangali, she is heartened by the progress she is seeing in the three months since her granddaughter has been taking medication and undergoing regular follow-ups.
“I hope she keeps getting better,” she says.
