Upskilling staff
at indigenous-led projects

The grassroots initiatives that we work with are run by wonderful local people. They have enormous compassion for people with mental health problems but typically don’t have the mental health skills and knowledge needed to provide high-quality support.

Rescue centre for the homeless, Kathmandu, Nepal

This project supports homeless and marginalised people struggling with severe mental illness such as schizophrenia or severe depression. A significant proportion of its patients are women who have been abandoned by their families because of their mental illness.

Since 2017, we have trained staff on violence prevention and how to prepare people for life after they leave the centre. This includes educating patients about the importance of continuing to take their medication.

In addition, we’ve helped staff to organise group sessions that teach people about different aspects of wellness, including diet, family and social life. And we’ve worked with whole families to help them think about family dynamics, duties and responsibilities and how they can provide the most effective support to a loved one struggling with mental illness.

Reaching remote communities

One of the key elements of our work is reaching and supporting people who receive no mental health support at all. Currently, this includes a vital but challenging project in a mountainous region of Nepal that has one of the highest rates of suicide in the country. In the future, we hope to reach many more remote communities across South Asia.

Training female community health volunteers in Ilam, Nepal

In rural Nepal, female community health volunteers (FCHVs) receive basic training before carrying out home visits to convey key health messages, including information about vaccinations, child birth and HIV prevention. Over recent years, this work has significantly contributed to a reduction in child mortality and an increase in the uptake of immunisation.

However, despite mental illness being prolific in rural communities, these health workers rarely receive mental health training. But now, thanks to our supporters, we are changing this. We are training FCHVs in basic mental healthcare and diagnosis, doing all we can to increase their status in their communities, and getting them involved in the shaping and delivery of services.

Already, this project has been so successful in Ilam that the local government has asked us to expand our work into other regions. This project has huge potential to be scaled-up in order to reach rural communities across South Asia.

After 6 months of receiving treatment from our mental health walk-in clinic


of service users felt valuable and useful


of service users felt able to enjoy normal day-to-day activities

Increasing children’s access to mental health support in their communities

As in many areas of South Asia, children in Nepal are at high risk of being affected by factors which adversely affect their mental health. These include poverty, child labour, trafficking and exploitation, domestic violence, sexual abuse, and natural disasters such as earthquakes and flooding.
Despite this very concerning issue, mental illness in Nepal, and especially amongst young people, has been largely ignored. The government allocates less than 1% of its total health budget to mental health, and child and adolescent mental health services receive a negligible portion of this.
To change this unacceptable situation, we are constantly exploring how we can increase children’s and young people’s access to mental health support in their communities.

Training school nurses (starting 2020)

In 2019, the Nepalese government allocated 430 qualified nurses to schools across the country. This new role is of great significance for school-age children, and especially those living in rural areas. This is because a school nurse is often the only qualified health professional a child, as well their parents, teachers and sometimes whole communities, have access to.

Certainly, the introduction of the school nurses is a positive step in the right direction. However, because they typically work in isolation, receive very little support and lack mental health support skills, the nurses are currently unable to provide effective support to children and young people with mental health and emotional problems.

Thankfully, the Nepalese government has also identified this issue and asked us to train all the nurses so they have basic counselling and mental health nursing skills. A hugely important programme of work that we will begin in September 2020.


Every year around 340,000 Nepali adolescents attempt suicide


school nurses





We are training over 430 school nurses in life saving healthcare skills, reaching out to some 21,500 children and adolescents across the 7 provinces of Nepal.

Empowering nurses to improve mental health support

In South Asia, nurses (who are predominantly female) are often best placed to provide direct mental health support to people and shape services so they are as effective as possible. But in the region, nurses, and especially psychiatric nurses, are greatly undervalued and sit at the bottom of a hierarchy of decision-making power that’s dominated by doctors (who are predominantly male).
To change this situation, we are providing mental health training to nurses and campaigning for decision makers to involve them in the shaping of services.

Training general and psychiatric nurses in Gokarneshwar, Nepal

At a large training hospital in Gokarneshwar, we run training programmes for general and psychiatric nurses that help them to meet the emotional and mental health needs of their patients. This includes us teaching nurses how to communicate effectively with their patients to establish trust and rapport, and how to help patients become more invested in their own recovery.

We have also worked with the hospital’s psychiatric nurses to advance their understanding of different therapies, because medication was previously the only treatment on offer. From 2018, this has included an art therapist from Jaya Mental Health holding sessions for patients. Initially, their work was met with scepticism; but after witnessing how it helped people to explore their thoughts and feelings, the therapy has been well received by staff on the psychiatric ward.

On top of improving the direct support provided by female nurses, we’ve encouraged and trained these women to be active decision makers rather than passive receivers of instructions; and we’ve created opportunities for them to work with key decision makers so they can influence and shape mental healthcare services.

Overall, we believe this programme of work has the potential to totally transform mental healthcare and recovery in Nepal if it becomes embedded in hospitals throughout the country.

“As nurses, our experience is not always recognised and appreciated by others. Jaya Mental Health has helped me realise that I am of value to myself and others.”

Rekha Karanjit, Staff Nurse

“Jaya Mental Health helped me understand the importance of offering person-centred care on the ward. Being a good listener and caring towards those we work with can really make a difference in their process of recovery”

Pratikshya Rai Staff Nurse, Psychiatric Inpatient Unit

Increasing mental health awareness to protect vulnerable people

In South Asia, a lack of education and awareness means stigma and prejudice still surrounds mental illness. This frequently leads to people, including healthcare professionals, ostracising and discriminating against those with a mental health problem.
This is why we are working hard to ensure healthcare professionals, key decision makers and the general public understand and recognise the causes, symptoms and support options for mental health problems.

Training healthcare staff in Rawalpindi, Pakistan (starting Spring 2021)

According to the World Health Organisation, the prevalence of mental health disorders in Pakistan is steadily rising against a background of growing insecurity, economic instability and terrorism. The recent Covid-19 pandemic has made things worse. In addition, mental health care infrastructure is dilapidated and, in some cases, inhumane.

Despite the high incidence of mental illness, the vast majority of healthcare staff working across Pakistan’s health services are unable to diagnose or treat mental health problems, and many discriminate against patients with mental illness.

To improve this situation, we will deliver mental health awareness training to hospital-based healthcare professionals – this will include identifying mental illness, providing effective support, understanding the challenges of mental illness  and the associated stigma and discrimination.

As a result, patients who have mental health problems will have their needs assessed and be provided with support that will improve their quality of life.

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