…qualified counsellors are critical in helping youth deal with problems

Yam Kumar Poudel and Yangyel Lhaden

Tshewang Rinzin, 21, volunteers at the scout division. He loves engaging with youth like him and advising them so that they don’t have to go through mental health issues like he did.

“I had many dreams when I was in school. I stopped dreaming now, but working with children and youth gives me happiness,” Tshewang said.

Tshewang is an only child. His parents separated when he was very young while studying at ECCD. Then, Tshewang found himself moving to different places and schools often. He was hardly in a place for a year when another guardian took him.

“I abused drugs for the first time in high school, the more I broke down, the more drugs I took in,” Tshewang said.

“Most things I did, I don’t remember because I was depressed, sad, and they were done under the influence of substances,” Tshewang said.

The guidance and care from his teachers helped him get over his mental health problems—Tshewang is recovering.

Counsellors share that they have observed a significant shift in the attitude of students about mental health issues. Many students can talk about mental issues unlike in the past.

“More parents are also realising the importance of recognising mental issues and coming forward to support their children,” a counsellor said.

The role of counsellors has also adapted to suit the current context, with peer counsellors, teacher counsellors, and clinical counsellors available both in person and online to assist young individuals in navigating various issues.

The government over the years has prioritised the improvement of psycho-social support programmes across the country in schools and institutions.

However, these changes have come after years of investment in capacity building and aggressive awareness campaigns.

The awareness programme in the schools and community through relevant agencies was attributed to have made this change possible.

Stress, anxiety, adverse childhood experiences, alcohol disorder, family-rooted issues and bully cases were some of the prominent cases reported to the counsellor by the survivors.

Kunzang Choden, an Assistant Counsellor at one of the schools, said that family intervention and counselling are crucial—guiding to live a better life. “Mental health should not be a taboo—everyone should be free to talk about mental health and related issues giving primary focus to self-care.”

There are concerns that students do not seek guidance and counselling from teacher counsellors who play the dual role of having to grade, discipline and counselling the students.

“Many people who are struggling with mental health problems are afraid to seek help due to fear of discrimination or ostracism. We need to create a more open and supportive society that encourages people to seek help when they need it,” she said.

The Ministry of Education and Skills Development (MoESD) initiated a school-based child protection committee with its members as immediate responders. Schools with peer helpers, scouts, and Y-PEER clubs actively engage students, raising awareness and encouraging openness about mental health. The programme benefited 4,022 students from 128 schools last year.

Chief Counsellor Reena Thapa highlighted collaborative efforts with other agencies to create a holistic approach, covering prevention, early identification, intervention, treatment, and support services.

Early intervention is crucial, involving roles for parents, caregivers, and educators, Reena Thapa said.

According to the State of the Nation Report 2023, about 24 gender and child focal persons (GCFPS) from across the country received training and were responsible for delivering timely service to women and children who needed care and protection. More than 1,700 teachers and principals also received training under the programme.

The education ministry has also trained 191 principals, 110 counsellors, and 358 focal teachers in some dzongkhags and thromdes to enhance counselling services in schools.

With the expertise and support from the PEMA Secretariat, there were additional projects in progress such as the Special Education Needs (SEN) programme aimed at enhancing support for certain vulnerable students.

In Bhutan, PEMA Secretariat was the overall planning and coordinating agency for mental health. It guides clinical research, training, and capacity building.

Dil Kumar Subba, programme officer of the PEMA Secretariat, pointed out the absence of a comprehensive study on definitive causes of mental health conditions in Bhutan. “However, on a global scale, it is widely recognised that the origins of mental health issues are multifaceted and interlinked.”

The Annual Health Bulletin of 2022, he notes, recorded 10,607 new cases. Anxiety disorder topped the list at 39 percent, closely followed by depression at 23 percent. Other diagnoses included alcohol use disorder (1,906), substance use disorder (579), psychosis (including schizophrenia) at 971, and others at 1,534.

Research conducted by the Centre of Bhutan and GNH studies reveals that between 2017 and 2021, 354 children, which is 13.8 percent of the total mental health disorders referred to Jigme Dorji Wangchuck National Referral Hospital and National Traditional Medicine Hospital, were school-going children.

The National Health Survey 2023 incorporates mental health as a component, aiming to provide insights into prominent risk factors within the Bhutanese context.

“While the analysis is still ongoing, it is expected to provide valuable insights into prominent risk factors for mental health within the Bhutanese context,” a secretariat official said.

While treatment for substance-related issues has begun at specific hospitals, the shortage of human resources limits service expansion. Contributing factors to the increasing number of youths seeking psychiatric help include job loss due to the pandemic, migration, academic competition, and heightened job market competition.

A clinical counsellor emphasises the need to recognise the underlying reasons for drug addiction in Bhutan, urging a focus on rehabilitation, counselling, and proactive solutions rather than punitive measures.