This blog was written by Mrs. Bina Silwal, the Executive Director of KOPILA-Nepal (WDR Partner). Bina looks at poverty in terms of mental health and wellbeing and shares Kopila’s experience.

KOPILA-Nepal (KN) was established as a non-government social organization in 2001 with a vision  towards a society in which the rights of all people are realized and basic needs are met.

The team at KOPILA-Nepal strives to ensure that the most marginalised people in their society can enjoy their fundamental human rights and psychosocial wellbeing. To achieve this mission, it has been working with the most marginalized women and children through developing and mobilising self-help groups, skill development training, education, psychosocial counselling, mental-health treatment, re-habitation & social re-integration and advocacy for rights. Kopila Nepal works with family, community members, school teachers, and policy maker/implementers to deliver these programmes.
Currently we are working in nine districts of Gandaki Province (Western Nepal). 

Various studies, globally and in Nepal, have reported the reciprocal relationship between mental health and poverty. KOPILA also have similar experience that psychosocial and mental health affect peoples' socio-economic status of individuals and their family. Though there is no statistical evidence, we have experienced that many families living in chronic poverty are at the highest risk of developing poor mental health and psychosocial problems in the community. 

During our work in the community we found several such examples and we realized that medication only does not heal mental health problems. Therefore, we need to find out the cause that triggered mental health or psychological problem and plan our intervention accordingly. As stated above, in the case of the community we found that poverty has significantly contributed to increased poor mental health and this has pushed the whole family into poverty. Poverty should not only be taken as economic poverty but powerlessness, poor social support network, discrimination, voiceless are different forms of poverty.
For example, in Nepal, there is huge gender discrimination. Women’s voices are not heard, they are not part of decision making. They may have money to spend but they are still poor. In rural Nepal people are discriminated based on gender, caste, ethnicity, disability and so on and they are at more risk of falling into mental health problems.

How poverty can affect mental health

Kopila Nepal works with poor and marginalized women who are widows, abandoned, abused or victims of rape. Their voice is not heard, and they are they do not have any power even to demand rights they are entitled to. They are having problems to provide for their children’s basic needs and feel highly unsecured and vulnerable. Most of these women have developed the symptoms of serious anxiety and depression. Kopila Nepal provides psychosocial counselling to help develop their self-esteem. Medication is provided only if their symptoms are serious and, where possible, support is provided to make some income. When they start earning, they feel more secure, their self-confidence improves and due to Kopila they realise that they are not alone in their fight. This helps their mental health and also helps women become independent. 

Ganga Magar 52, a single mother, lives in Taprang village with her 3 children. She got into mental health problem due to difficulty to provide her children, Kopila-Nepal referred her for mental health treatment, counselling and provided goat-keeping training and business skills. She now earns enough to meet the basic needs of the family and can send her children to school. 

Mangali Ranabhat, 49, a resident of Madi 4, Thumako Danda suffered from poor mental health after the death of her husband. Due to her poverty she could not afford treatment as it is not available at local health centre in the village. Kopila Nepa also l supported her for her treatment, provided counselling and supported for goat-keeping business. She now is sending her daughter to school and is managing her home well with the income she makes. 

There are several stories of people and families whose mental health is suffering due to poverty. Kopila Nepal knows that this problem cannot be healed only by medication but needs a proper counselling. Furthermore, to help provide a solution, we must continue to identify the triggers for poor mental health in these circumstances.