Caste in Mental Health Service and Policy in Nepal
A few small-scale researches conducted in Nepal have shown that Dalits often have higher rates of mental health disorders than the so-called ‘upper castes’. Dalits’ own caste identity has become a major contributor to mental health problems. Caste-based discrimination, humiliation, and indignity are important factors, among others, that have been associated with the high risk of mental health illness among Dalits. Yet, caste has not been a subject of public discourse. In this context, this paper examines how caste is understood, perceived and treated in Nepal’s psychiatry.
In the paper, I address three central questions: to what extent does the caste appears in the formation of mental health policies and plans? To what extent do the service provider agencies consider caste issues while developing their own or following treatment protocols? To what extent does the mental health educational program include caste in its course curriculum? I review a) the government’s mental health policies, plans, and strategies, b) the treatment protocols used by service providers, and c) the curriculum of the universities that run education programs in mental health.
I argue that caste has been periphrastically side-lined in the formation of mental health policies/strategies and intervention protocols. This paper finds that the Nepalese psychiatric stakeholders have never officially recognized caste discrimination and untouchability as mental health problems. Additionally, my paper demonstrates that the universities that offer mental health courses has not given priority to include caste in their syllabuses. The results of this paper consider the possibility that the inclusion of caste in mental health policies and protocols, as well as in teaching curriculum, can contribute in achieving of quality mental health services for Dalits.
Keywords: caste, mental health, policies, education, and protocols