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Comprehensive Strategy to Address Mental Health and Suicide Prevention-The PEMA

โ€ฆ๐’„๐’๐’๐’๐’‚๐’ƒ๐’๐’“๐’‚๐’•๐’Š๐’—๐’† ๐’”๐’•๐’“๐’‚๐’•๐’†๐’ˆ๐’Š๐’†๐’”, ๐’‚๐’„๐’„๐’†๐’”๐’”๐’Š๐’ƒ๐’๐’† ๐’”๐’†๐’“๐’—๐’Š๐’„๐’†๐’”, ๐’‚๐’๐’… ๐’‘๐’“๐’๐’‚๐’„๐’•๐’Š๐’—๐’† ๐’Ž๐’†๐’‚๐’”๐’–๐’“๐’†๐’” ๐’๐’†๐’‚๐’… ๐’•๐’‰๐’† ๐’„๐’‰๐’‚๐’“๐’ˆ๐’† ๐’Š๐’ ๐’•๐’‚๐’„๐’Œ๐’๐’Š๐’๐’ˆ ๐’Ž๐’†๐’๐’•๐’‚๐’ ๐’‰๐’†๐’‚๐’๐’•๐’‰ ๐’Š๐’”๐’”๐’–๐’†๐’”

Phurpa Wangmo

Taking a bold step towards tackling mental health challenges and preventing suicide, The PEMA has initiated a comprehensive and multi-sectorial approach. Collaborating with relevant organizations such as education, health, civil society groups, communities, and social services.

The PEMA is working to promote protective factors and prevent risk factors for mental health in a phased manner.
An official from The PEMA Secretariat, emphasized the multifaceted nature of mental health issues and suicide, which can stem from various factors such as mental health disorders, social issues, relationship problems, substance use, lack of access to mental health services, and exposure to adverse life events. Recognizing the complexity of these underlying causes, The PEMA is actively consolidating and coordinating efforts with all relevant organizations to implement comprehensive strategies for preventing mental disorders and suicide incidence.

The Royal Government of Bhutan has also recognized the link between substance use and mental health issues, with an increased risk of suicide and other social problems. To combat this issue, the government has pledged to address substance use through a national-level implementation plan, encompassing efforts to reduce both substance demand and supply.

Sustaining prevention efforts and establishing comprehensive mental health services require adequate financing and commitment. The Royal Government has allocated substantial funding to various areas for mental health interventions, including infrastructure development, prevention initiatives, well-equipped facilities, and human resources development. With this enhanced financing, The PEMA aims to lay a robust foundation for a comprehensive and sustainable mental health system. However, current priorities involve addressing gaps in infrastructure, early identification and treatment, improving the quality of mental health care, ensuring accessibility of services, and consolidating services.

Creating awareness is a vital component of prevention efforts, empowering individuals through self-care practice, early recognition of signs and symptoms, and promoting help-seeking behaviors while reducing stigma. Collaborative efforts from agencies and experts have led to the development of standard Information, Education, and Communication (IEC) materials designed to promote mental health, increase understanding, reduce stigma, and encourage help-seeking behavior among the general public. Leveraging technology, social media handles have been created to regularly share these IEC materials, while media outlets like BBS 3 broadcast and promote them to reach a broader audience.

The PEMA focus on accessibility to mental health services involves strengthening integrated mental health care within general healthcare services. Mental health services will be inclusive and accessible to all individuals, regardless of vulnerabilities, to meet the diverse needs of the population.

To achieve this, the PEMA is recruiting mental health professionals like Clinical Counselors in Dzongkhag hospitals to expand therapy services. Furthermore, pre-service training of Clinical Counselors in Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB) has been increased to address the growing demand for services in communities. Recognizing the importance of equipping health professionals working in communities, basic mental health care skills will be provided through immediate training, along with the establishment of proper referral pathways to ensure holistic and coordinated care for individuals in need.

According to an official, comprehensive mental health services must include crisis intervention and response services for individuals experiencing mental health crises. The PEMA has established a dedicated helpline for mental health, managed by professional counselors.

These counselors offer counseling services, instant mental health-related information, and facilitate referrals for mental health and other relevant services. The helpline’s effectiveness in catering to more than 140 individuals from all parts of the country underscores its importance in providing efficient crisis interventions, including those experiencing suicidal behaviors. As part of ongoing efforts, a proactive prevention strategy focusing on early identification through well-being screening in schools is being developed. This strategy aims to enable early identification and timely interventions for potential mental health issues among students. Moreover, schools are working in collaboration with relevant departments to create a supportive environment that fosters the mental well-being of students, ensuring nurturing spaces, access to mental health services, and an established referral system.

The PEMA recognizes the crucial role of postvention services in providing vital support to individuals affected by the loss and helping prevent further distress among survivors after suicide incidents. To address this, PEMA is in the process of instituting a mechanism to reach out to survivors and provide necessary support during such events. This support includes offering counseling services to cope with grief and complex emotions that often accompany such incidents, fostering healing and resilience for survivors while mitigating long-term effects.

Research and a robust information system play a pivotal role in mental health, providing evidence-based interventions and decision-making tools. Advances in technology have made system-based screening for early identification highly effective in improving timely referral and mental health outcomes. The PEMA is currently working on establishing a system to aid in screening for timely detection and effective management of underlying mental health issues. The ongoing National Health Survey includes a specific module on mental health indicators, providing foundational data to guide future initiatives and tailor approaches. Research activities are prioritized in areas of service enhancement and evidence-driven decision-making for all initiatives.

To ensure a coordinated approach and consolidation of efforts, a National Multi-sectorial Mental Health Strategy is under formulation. This strategy will involve reviewing all existing policies, strategies, guidelines, and services, serving as an overarching guiding document for mental health-related interventions in the country, aligned with the broad mandates of the PEMA. Specifically, the existing Suicide Prevention Strategy will also be reviewed and integrated into the broader mental health strategy, emphasizing prevention and response services.

As of July 13, the Royal Bhutan Police reports a total of 45 suicide cases in the country this year. PEMA remains unwavering in its commitment to addressing mental health challenges and preventing suicide through collective and sustainable measures.

The PEMA’s guiding principles encompass proactive and responsive mental health service delivery, enabling an efficient mental health system, fostering multi-sectorial collaboration, and advocating for prevention to alleviate the burden of mental disorders, stigma, and discrimination associated with mental health issues.

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