Innovative Policy 2019 on Independent Living and Political Participation

A nationwide strategy to fight mental health issues

The National Mental Health Programme was launched in 1997 to provide community-based mental health care services and to educate society about mental health protection, prevention, and possible treatment. With a well-established national primary health care network, Bhutan is now working to train doctors, health care workers, and nurses on mental health treatment skills; to provide appropriate medication; and to integrate mental health into general primary health care services. Between 1997 and 2018, 300 primary health care doctors, 450 primary health care workers, and 400 nurses have been trained.

“My elder brother developed schizophrenia at the age of 19. We performed all traditional rituals and treatment available at that time but in vain. So, he was locked inside a room for more than 12 years. Only after I became a medical doctor in 1987 and later a psychiatrist in 1999, we were able to provide effective treatment to him.”

Chencho Dorijpsychiatrist
About the policy at a glance
Laws and regulations involved:National Mental Health Programme and the Bhutan Penal Code
Responsible Body:Government of Bhutan
Country
of Implementation
Bhutan

FACTS & FIGURES

  • In 2017 the county had 345 doctors (including specialists), 25 clinical officers, 1,264 nurses, and 600 health assistants.
  • As of 2018, about 86 per cent of general doctors, 25 per cent of nurses and 75 cent of primary health care workers have been trained.

PROBLEMS TARGETED

In Bhutan, lack of awareness, myths, shame and stigma are still common regarding mental health issues, and consequently many people hide their symptoms and do not access treatment.

SOLUTION, INNOVATION, AND IMPACT

People during an initial interview.

Implementation of the National Mental Health Programme starts with visits by a mental health service team to community leaders, local health care personnel (doctors, health care workers, and nurses), as well as to traditional healers to discuss existing practices and to understand their perspectives and gain their cooperation. This is followed by education and training to introduce modern mental health concepts and their advantages. Together with community leaders, local health care personnel, and traditional healers, the mental health team identifies potential cases in the community and provides training in basic psychiatric skills, such as diagnosing and treating common mental health issues. Once the identified cases are interviewed and diagnosed, the team supports the local health workers in creating individual treatment plans, which include consultations with families and gaining their involvement in supervising medications and providing emotional support. To sustain the service level, local health workers follow-up on individual cases in clinics or through home visits. At the national level, a core team of mental health specialists visit the primary health centres regularly to monitor activities and to provide clinical supervision.

OUTLOOK, TRANSFERABILITY AND FUNDING

Since its founding, the National Mental Health Programme has cost approximately $40,000 per year and is entirely funded by the government with additional donations from the WHO. In 2017, there were 345 doctors (including specialists), 25 clinical officers, 1,264 nurses, 600 health assistants, and 36 basic health workers working in clinical and primary health care settings. As of 2018, approximately 300 doctors, 400 nurses, and 450 primary health care workers have been trained in all parts of the country. There are three training teams, each lead by a psychiatrist. In addition, support is provided by more than 20 staff members, including volunteer mental health professional from abroad.

The plan is to train at least 30 individuals from each category of health professionals per year, with a priority on primary health care doctors and health workers.

CONTACT

Chencho Dorji
chenchodorji@gmail.com

FACTSHEET

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