Mental health-related structural stigma and discrimination in health and social policies in Nepal: A scoping review and synthesis.

AIMS: National policies can be used to reveal structural stigma and discrimination in relation to mental health. This review assesses how structural stigma and discrimination are manifested in the policies and legislations of Government of Nepal. METHODS: Scoping review methodology was followed to review policy documents (acts of parliament, legislation, policies, strategies, guidelines and official directives) drafted or amended after 2010. RESULTS: Eighty-nine policies were identified related to health, social welfare, development and regulations which were relevant to people with psychosocial and mental disabilities or have addressed the mental health agendas. Several critical policy failings and gaps are revealed, such as the use of stigmatizing language (e.g., 'insane' or 'lunatic'), inconsistencies within and between policies, deviation from international protocols defining legal capacity and consent, lack of inclusion of the mental health agenda in larger development policies and lack of cost-effective interventions and identification of financing mechanisms. Provisions for people living with mental health conditions included adequate standard of living; attaining standard mental health; the right to exercise legal capacity, liberty and security; freedom from torture or discrimination; and right to live independently. However, other policies contradicted these rights, such as prohibiting marriage, candidacy for and retention of positions of authority and vulnerability to imprisonment. CONCLUSION: Mental health-related structural stigma and discrimination in Nepal can be identified through the use of discriminator language and provisions in the policies. The structural stigma and discrimination may be addressed through revision of the discriminating policies, integrating the mental health agenda into larger national and provincial policies, and streamlining policies to comply with national and international protocols.

Population pressure and land resources in Nepal: a revisit, twenty years later.

PIP: This study analyzes the changes in the relationship between population and land resources in Nepal from 1971 to 1991. During this period, the country's total population increased by 7 million people while it's national per capita holding of cultivated land dropped significantly from 0.17 to 0.13 hectares. However, it was noted that there is a greater balance in the regional distribution of population and land resources in 1991 as compared to 1971. A shift in the redistribution of population can be accounted to the migration of the people from the Hills to Tarai. The large agricultural area in Tarai contributes to its underpopulated status compared with the Hills in relation to the total agricultural production. The increase in rural population is the direct result of poverty, and the inability of the Nepal government to grant lands to the Hill migrants resulted to land encroachment. The problem of Nepal is not simply the number of people living in an area nor the interregional migration, but the number of people who have and who have no access to land and forest resources.^ieng