Nepal’s mental health system from public health perspective: a thematic synthesis based on health system building blocks

Abstract

This study evaluates Nepal’s mental health system through the World Health Organization’s six building blocks: governance, financing, workforce, service delivery, essential medicines, and information systems. Despite policy advances toward integrating mental health services within primary care, significant challenges persist, including governance fragmentation, workforce shortages, insufficient funding, inconsistent availability of essential psychotropic medications, and a weak health information infrastructure. Federalization has introduced both opportunities and challenges for mental health governance across the different tiers of government. Stigma, resource constraints, and limited coordination further hinder service accessibility. This study identifies actionable priorities, including strengthening workforce capacity, expanding community-based services, enhancing inter-sectoral collaboration, and improving access to essential medicines. Addressing these issues through targeted policies and increased funding is crucial to build a more equitable and effective mental health system in Nepal, capable of addressing the rising burden of mental health disorders.