“ONE school had four suicides in six months, and by the end of that six months hardly any children were sent there as parents felt there was a problem with the school and kept their children away.”

In the decade since Dr David Sims, Child and Adolescent Psychiatrist for Bradford District Care NHS Foundation Trust has given up his annual leave to embark on self-funded trips working on child and adolescent mental health training projects in Nepal, mental health issues are now discussed more openly at school.

Young people know where to go for help and parents, previously frightened to send their children to school through fear mental ill health was contagious, are more informed with trained teachers educating them to dispel those myths.

The school is beginning to flourish and training is now being rolled out to other schools to help facilitate shared learning.

Church leaders and their congregation also recognise how powerful and effective talking about mental health can be and how asking someone how they are feeling can help support emotional wellbeing.

David, who has been to Nepal seven times in the last 10 years with the faith based medical education charity Prime International, who deliver whole person healthcare training around the world, explained: “During the trip we spoke to church leaders, particularly about people committing suicide, as the figures for suicide are at least double of those in the UK. The community leaders want to help as there are no mental health nurses, one child psychiatrist, less than 30 clinical psychologists and less than 200 mental health specialists’ in a population of 30 million.

“The community leaders are increasingly becoming aware of the problem of suicide through the number of people they meet. Within our training we’re equipping people to understand about mental health and also to have conversations with those most vulnerable.”

And, as David explains, it can be lifesaving: “We work in groups of three, getting people to practice the sorts of conversations they’d have in a session. One of the people on the course left the group at the end of the second day to go talk to someone straightaway who was at risk of suicide. So, it’s a really practical course. The person was able to implement the learnings and hopefully help to save a life. This is why I go back – because every time I go I have conversations about lives that have immediately been impacted.”

David talks of the young man, now in his 20s, who they met in a village five-or-six years ago. He recalls he was ‘one of the most severely mentally ill people I have ever come across.’

“The villagers brought him to the training meeting we were having after they’d heard we were there. We spoke to the villagers and asked them to talk to the boy’s family to get him much needed treatment. The next time we went he was recovering after a period in hospital. He’s now in college, he’s studying and also contributing work wise to his family. These are the stories and people that keep me going back.”

As well as helping to break the stigma of mental health they are also proving ‘talking and listening really makes a difference.’

“For many people it will be the first time they’ve been listened to. We also let people know there are mental health services and psychiatrists that can help.”

Up to six months ago there was only one child and adolescent mental health services (CAMHS) specialist in the whole of Nepal. Working with Consultant Child and Adolescent Psychiatrist, Dr Arun Kunwar, David is now training three more psychiatrists to help bridge the gap when Dr Kunwar retires in the next few years.

Along with working as a child and adolescent psychiatrist at the Care Trust, David has over twenty years’ experience training healthcare professionals in the UK.

“The rates for mental ill health for teenagers in Nepal are higher than in the UK. Children are admitted to hospital, because they don’t know what to do with these young people, which doesn’t help to tackle the mental health issue. We’re hoping that by equipping people in the community, as well as going to international conferences to speak to healthcare professionals, we’re beginning to work at different levels to make a difference.”

Stigma, lack of knowledge and discrimination can trap people in a cycle of illness. With training and education children and young people in Nepal have the potential to live normal and fulfilled lives.