I am a Developmental Psychologist, narrative and somatic practitioner, and EMDR therapist from Hyderabad, India, living and working in Nepal (and other parts of Asia) on and off since 2008. I always wanted to work in the humanitarian mental health field with marginalised communities. I found my way to Kathmandu, Nepal, in 2008 working for an organisation that supports children who live on the street and have experienced child sexual abuse. I started my work in this sector by working with a team of social workers who were providing psychosocial support to urban economically disadvantaged families. I moved to Nepal a couple of years after the end of the decade-long armed conflict and I have worked from there for most of the years since.
Nepal’s mental health services have a robust foundation in community-based support and collective healing, which aligns with the cultures and traditions of this region emphasizing a strong connection to community. In Nepal’s recent history, communities have experienced a decade-long armed conflict, between 1996 and 2006, and two earthquakes in April and May 2015, amongst other frequent disasters such as floods and landslides. These events have had a significant influence on the development of mental health and trauma work through community-based projects. More recently a private sector for mental health services is emerging from the experience of these community-based projects.
The country’s mental health and psychosocial care sector grew around these events and their effects on communities in rural and remote areas. The needs of these communities have been historically neglected where most of the health, education and social services available were restricted to the capital Kathmandu. Though the services still continue to grow at a faster pace in the city and diversify into private services, the community-based mental health movement still thrives. Organisations that work with communities in conflict, survivors and victims, marginalised groups, and organisations working for women’s rights and with survivors of gender-based violence routinely include mental health and psychosocial support as part of their initiatives.
Organisations like Transcultural Psychosocial Organisation Nepal and the Centre for Mental Health and Counselling have been working in the mental health and psychosocial support sector for many years. Their projects focus broadly on developing resources and skills in the public health and public education sectors to support mental health, as well as developing and implementing psychosocial counselling training programs and mental health research. One such training program has produced a number of psychosocial counsellors who work in the NGO and community-based mental health sector. They work with a diversity of issues with children, with mothers in maternal mental health, and people experiencing mental health conditions in rural and remote areas. These psychosocial counsellors have formed the backbone of the psychosocial support services in Nepal.
There are many organisations that are not mental health organisations but do important community work that helps communities heal. Feminist organisations like Tarangini, working with women human rights defenders, and Maiti Nepal, working against the trafficking and exploitation of women, routinely incorporate psychosocial and mental health care in their work. Even though they may not use the words “trauma-informed,” these organisations have an understanding of trauma from the lived-experiences of the women they support, and have developed and built their practice to respond to those experiences. Another feminist organisation The Story Kitchen (TSK) is a space to amplify “herstory”. They have been working with women survivors of the armed conflict, facilitating safe spaces and documenting their stories. Using feminist principles and narrative practices, TSK has facilitated many spaces where women ‘victims’ of the conflict have come together and, through thoughtful facilitation, TSK team has created spaces for women to share their stories and find individual and collective healing. These workshops have the intention of supporting women whose stories have never been told or heard to come together to share with each other and witness each other’s stories. The workshop is carefully designed to allow for participants not only to tell their stories of violence if they wish to, but also stories of their ‘survival skills.’ This invitation allows women to expand their identities to include stories about their skills and qualities that help them get through and live with their difficult experiences.
In the recent years, organisations offering mental health support in the private sector are emerging, with organisations like MannKa kura, Happy Minds and Samata Psychosocial Care, amongst others, offering mental health services for private clients and group sessions for organisations. Many of the professionals working in these organisations have previously worked with community-based organisations and marginalised communities. These experiences inform their work and practice in a significant way.
It has been a significant influence on my professional journey to learn from the work of all these organisations and the communities they work with to realise that making community-based work, group work and collective healing work accessible to rural and marginalised communities is important.