Going by World Health Organisation (WHO) data, Nepal ranks very high in suicide rates, with 15 people taking their lives every day, on average. The country ranks seventh in the world for suicide rates and also ranks third for suicide rates among women between the reproductive age of 15-49 years. With 24.9 suicides recorded per 100,000 people in 2012, the last year for which comprehensive WHO statistics are available, Nepal has the second-highest rate in Southasia, with only Sri Lanka having a higher rate at 28.8. Studies have also found that attempted suicides are up to 20 times more frequent than completed suicides.
Social stigma, lack of awareness and discrimination against those suffering from mental illness are detrimental to addressing the crisis. Inadequate research and reporting makes it even more difficult for mental healthcare providers to reach out to those in need. In fact, when a suicide does make headlines, it is often in the form of a sensationalised news item on a freak event. When a Grade 10 student in Sunsari district in eastern Nepal took her life after her favourite football team, Brazil, lost to Germany in the 2014 World Cup, it was seen as an odd occurrence. The story was played up more for its shock value than as a pointer to a wider societal issue. This kind of coverage that promotes sensationalism without any reference to underlying causes is counter-productive to efforts to address the high suicide rate in Nepal.
Matrika Devkota, chairperson of Koshish Nepal, an NGO that works on mental health, talks about the 'silent suffering' of people with mental health problems. Devkota himself had been affected by mental health issues; he spent over 10 years struggling with depression before an unsuccessful suicide attempt left him in a coma for 72 hours. When asked what the major problems surrounding mental health and suicide in Nepal are, he says that those who are suffering do not realise that it is a common ailment. Often considered a sign of weakness, many leave the condition unattended, citing fate or punishment for actions committed in a past life. Since suicide is illegal in Nepal, it creates more barriers and stigma for those who need help as unsuccessful attempts are unlikely to be reported. This limits the reach of mental health professionals, NGOs and researchers. To counter this, Koshish is trying to break down the layers of stigma, misunderstanding and prejudice that mental health faces through advocacy. As Devkota puts it, one of the major aims of Koshish is to 'normalise suffering'. Creating an environment where talking about emotional issues is not seen as a sign of weakness but strength would be a major breakthrough for mental health issues in Nepal.
He also highlights high levels of migration in Nepal, and the perceived lack of opportunities for those who stay at home. "Every 12- or 13-year-old you speak to and ask about their dream, it is to settle abroad. This is surely an indication of how things are here." Large parts of the country, particularly rural and hilly areas, suffer from a chronic lack of development. Healthcare, education and employment prospects are bleak more often than not. However, whilst poverty plays an intrinsic role, it is not the sole determining factor. This can be seen in the case of Nepal's eastern district, Ilam, a district with high economic and literacy indicators, which also sees a high rate of suicides. In an interview with the Nepali Times, Bhupal Khatiwada of the Namsaling Community Development Centre, which ran campaigns to raise awareness about mental health issues when the number of suicides escalated in the district in 2014-15, outlined what he thought was the kernel of the issue: the immense pressure on young men to leave home to go study or work abroad, and, ironically, the sense of isolation experienced by the older generations when they were being left behind.