A Letter from Nepal

Pragya Shrestha

The Lancet Psychiatry

Published on: July 2020

Abstract: In Nepal, there is a scarcity of population-wide mental health services in most parts of the country. Mental health services are concentrated in a few hospitals located in the big cities; consequently, there is a huge gap between the number of people with the need for mental health care and those actually receiving services. In response to this, Transcultural Psychosocial Organization (TPO) Nepal was formed in 2005, with the aim of providing psychosocial and mental health services through development of a community based, culturally appropriate, and sustainable mental health care system ( www.tponepal.org). I joined TPO Nepal as a translator in 2007. I shifted my work from translator to clinician after completing a post-graduate diploma in counseling psychology from Tribhuvan University, Kirtipur, Nepal. Furthermore, I have been trained in several specific psychotherapies and interventions such as art therapy and cognitive behavioural therapy. Since then I have been involved in multiple projects as a counselor, trainer, and clinical supervisor that aim to integrate mental health services into primary and community care systems. As task-sharing has widely been advocated to minimise the tremendous treatment gap of mental health care in settings like Nepal, in this letter, I share my experiences in training and supervision of community health-care workers by using a task-sharing approach.


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