Transforming Lives
Bringing Hope and Sustainable change to Myagdi, Baglung and Nawalpur
4,172
Mental Health
Service Beneficiaries
1,862
Members in 98
self-help groups
3
Carers' Cooperatives established.
Our 3 Core Principles
INCLUSIVITY
Actively assisting individuals with mental illnesses and supporting marginalized groups, including carers, Dalit families, single women, and those living in extreme poverty. We are committed to ensuring that no one is left behind.
EMPOWERMENT
Expanding opportunities through awareness, vocational training, capacity building, and sustainable financial growth, enabling individuals and communities to thrive.
SUSTAINABILITY
Promoting mutual aid networks, including cooperatives that are capable of self-management, and supporting income-generating activities to foster economic independence and long-term stability.
Our Programs in Action
The leads Nepal Model to Integrate Mental Health and Development in Rrur
Mental health is often neglected when considering overall well-being, especially in rural areas and among socially disadvantaged communities.
In Nepal, limited access to mental health services leaves vulnerable individuals at a greater risk of developing mental illnesses. To address the challenges these communities face, it is essential to integrate mental health support into broader development strategies
Click to expand.....
Mental health is often neglected when considering overall well-being, especially in rural areas and among socially disadvantaged communities.
In Nepal, limited access to mental health services leaves vulnerable individuals at a greater risk of developing mental illnesses. To address the challenges these communities face, it is essential to integrate mental health support into broader development strategies.
This is the reason why LEADS has designed a model that integrates mental health care with community development, addressing both individual needs and broader social challenges.
The direct link between poverty and mental health
People living in socially disadvantaged conditions, including those in rural Nepal, are particularly susceptible to mental health issues. The stress of poverty, limited access to education, unemployment, and stigma often exacerbates the challenges of mental illness.
The World Health Organization (WHO) highlights the importance of targeted development strategies to support individuals with mental health conditions, who often live in poverty. Addressing this overlap between mental health and socio-economic disadvantage requires a comprehensive approach that considers both medical and social factors.
The LEADS Nepal model: empowering communities through integrated mental health care
Established in 2009, the LEADS Nepal Model is a pioneering community-based approach that integrates mental health services into development programs, empowering communities and strengthening local health systems.
The model operates on the principle that local empowerment is key. By involving trained local stakeholders, such as health workers and community members, LEADS Nepal helps identify individuals in need of mental health care, facilitating access to services that might otherwise be out of reach. This model aims to break down the barriers of stigma, cost, and geographical isolation that often prevent rural populations from seeking treatment.
The LEADS Nepal approach to providing accessible mental health care in remote areas
The LEADS Nepal program operates primarily in the Baglung and Myagdi districts, areas where agriculture is the main source of livelihood and access to healthcare is limited due to the remote nature of the villages. The program is now extending to Nawalpur district, further expanding its reach to support more communities in need of mental health services.
In response to the long travel and high costs of accessing mental health services, LEADS launched the Mental Health Camps (MHC) program in August 2010, bringing mobile clinics to local health posts. These outpatient services reduce travel and expenses, making mental health care more accessible in remote areas.
By offering on-site mental health services, LEADS Nepal improves access to treatment while providing continuous support through regular visits and follow-up care. The program combines mental health interventions with community development efforts, ensuring that patients receive comprehensive care that addresses both their medical needs and livelihood support.
Outcomes and impact: positive change in communities
The impact of the LEADS Nepal Model has been significant. By March 2011, 311 patients had been registered in the program, with 269 showing clinical improvement. This indicates a successful model for treating mental health conditions, even in challenging rural environments.
Additionally, the program has significantly reduced travel costs for patients and improved access to essential medications, making treatment more affordable and manageable for families already facing financial difficulties.
Beyond medical care, the program also emphasizes livelihood support for individuals with mental health conditions. By providing skills training and business grants, LEADS Nepal has helped many participants generate income, improving their economic standing and enhancing their overall quality of life.
This dual approach of addressing both mental health and livelihoods has proven effective in fostering long-term recovery and community resilience.
Challenges facing the LEADS Nepal model: logistics and workforce shortages
Despite the success of the LEADS Nepal Model, there are challenges to overcome. The remote locations of the villages create significant logistical difficulties, with many areas being difficult to access by road. This makes it challenging to provide consistent and comprehensive care to all who need it, particularly in more isolated communities.
Additionally, the demand for mental health services often exceeds the availability of trained personnel and psychiatric support. The shortage of qualified mental health professionals in rural areas continues to be a major barrier to the program's expansion and long-term sustainability.
A lasting impact: the success of the LEADS Nepal model in integrating mental health and development
LEADS Nepal highlights the potential of integrating mental health services into community development efforts, particularly in rural and underserved areas.
Despite facing logistical challenges, the program has demonstrated that a community-based, integrated approach can significantly improve access to mental health care while simultaneously addressing the broader socio-economic issues that many individuals face.
By empowering local communities and prioritizing both mental health and livelihoods, the LEADS Nepal Model serves as a valuable example of how mental health can be successfully integrated into development strategies, creating lasting impact in rural Nepal.ng impact in rural Nepal.
CARER COOPERATIVES:empowering carers and strengthing communities for a sustainable future
Carer Cooperatives are not just financial institutions; they are transformative lifelines for communities, empowering individuals—especially women—to break free from poverty and marginalization. By promoting economic independence, solidarity, and advocacy, CCs are paving the way for a more inclusive and sustainable future for carers and their families.
Click to expand....
Carer Cooperatives are not just financial institutions; they are transformative lifelines for communities, empowering individuals—especially women—to break free from poverty and marginalization. By promoting economic independence, solidarity, and advocacy, CCs are paving the way for a more inclusive and sustainable future for carers and their families.
LEADS Nepal is dedicated to expanding this powerful model, ensuring that no carer is left behind in the journey towards empowerment and opportunity.
How do Carer Cooperatives empower individuals and strengthen communities?
They empower individuals and strengthen communities through a holistic approach that addresses both economic and social needs.
1. Economic Empowerment: Offering carers opportunities for Income Generating Activities, fostering financial independence, and reducing stigma, particularly for women.
2. Training & Capacity Building: Providing essential skills in governance, financial management, and advocacy to help carers manage cooperatives and advocate for their rights.
3. Access to Resources: Facilitating revolving funds and connections to government schemes and microfinance, supporting carers in sustaining income-generating activities.
4. Networking & Advocacy: Empowering cooperatives to engage with local governments, advocating for carers' needs and promoting mental health and socio-economic security.
What's the impact of Cooperatives?
Cooperatives have a significant impact on individuals and communities by driving positive change in various ways:
- Financial Empowerment by encouraging saving habits and fostering participation in income generating activities, Cooperatives help reduce poverty and build long-term financial stability.
- Women’s Inclusion with 71% of female members benefiting from these programs, cooperatives enable women to achieve financial independence and security, helping to bridge gender gaps in economic participation.
- Advocacy and Solidarity enable cooperatives to amplify carers' voices, ensuring their concerns are reflected in local development agendas and government programs that promote their rights and needs.
- Economic security is achieved by supporting carers in establishing sustainable livelihoods, with cooperatives fostering community and collective strength to create a more secure future for members and their families.
LEADS Nepal's Cooperatives and their impact
LEADS established two cooperatives in the districts of Baglung and Myagdi in 2016, and a new cooperative is currently being set up in the district of Nawalpur. Through these cooperatives:
- 195 active savings accounts have been established in Baglung, and 210 in Myagdi, promoting financial responsibility and creating new economic opportunities.
- 1,165 carers have received microloans ranging from NPR 20,000 to NPR 100,000, enabling them to launch and sustain income-generating activities.
These savings accounts and microloans have had a remarkable impact, not only empowering carers but also driving economic growth.
Additionally, the Carers Agri-Product Business, a registered entity in Kathmandu, has been established to help collectively brand and market the products made by carers, allowing them to reach larger markets and maximize their economic impact.
Sustainability and empowerment of Carer Cooperatives
The sustainability of the cooperatives is rooted in their formal registration, which provides carers with a recognized platform to engage with local governments and stakeholders.
LEADS Nepal focuses on building the capacity of carers, preparing them for long-term self-reliance and effective advocacy. The ultimate goal is for these cooperatives to operate independently, with the skills and resources needed to thrive without ongoing support from LEADS.
Future goals for Carer Cooperatives
The project aims to expand and connect district-level carer cooperatives into regional cooperatives, amplifying their collective influence and bargaining power.
It also seeks to broaden inclusion by establishing new cooperatives in targeted districts, with a focus on women and marginalized groups.
Additionally, the project will enhance advocacy by using CCs as platforms to advance carers' rights and achieve long-term financial independence.
LEADS Nepal is committed to expanding this transformative model, ensuring that carers are recognized, supported, and empowered for a sustainable future.
LEADS' pioneering Mental Health Camps and mobile-enabled Follow-up Clinics in Rural Nepal
LEADS Nepal, in partnership with BasicNeeds UK, has been running a mental health and development program in Baglung and Myagdi districts since April 2010. The program helps people with mental illnesses and epilepsy recover and supports their families with livelihood opportunities.
Click to expand....
LEADS Nepal, in partnership with BasicNeeds UK, has been running a mental health and development program in Baglung and Myagdi districts since April 2010. The program helps people with mental illnesses and epilepsy recover and supports their families with livelihood opportunities.
LEADS works closely with government health institutions to train health workers, improve mental health services, and influence policies. It also advocates for better access to mental health medicines and aims to integrate mental health care into rural health facilities. Through trained health workers and volunteers, the program raises awareness and ensures communities receive the support they need.
Mental Health Challenges in Rural Nepal: The Impact of Poverty, Violence, and Gender Discrimination
People in the program area face a high risk of mental illness due to poverty, violence, past conflict, and substance abuse. Hill districts have high suicide rates and many mental health problems, but the nearest mental health service is in Pokhara. Those with mental illnesses often face stigma and exclusion from family and community life. In severe cases, they may be locked up, violating their rights. Mental illness also creates challenges for employment—both for the affected person and their carers.
Women, especially poor and marginalized ones, are more vulnerable due to gender discrimination. They have fewer rights, lower literacy, and face high levels of gender-based violence, which is worse for those with mental illnesses.
Challenges in Mental Health Services in Nepal: Limited Access, Resources, and Expertise
In Nepal, access to mental health care is severely limited, particularly in rural areas. Local health posts lack mental health drugs, and district hospitals have only a limited supply. There's no emergency mental health plan in place, unlike the emergency protocols for general health, and many healthcare workers cannot prescribe psychotropic medicines due to strict regulations.
Nepal also suffers from a significant shortage of mental health professionals. The country has only 0.59 mental health professionals per 100,000 people, including 32 psychiatrists, 16 general doctors, 68 nurses, and 6 psychologists. There are no social workers or occupational therapists. The sole mental hospital in Kathmandu has just 50 beds and primarily serves low- and middle-income patients, with 750-800 inpatients and 23,000 outpatients annually.
A critical issue is the lack of government mental health services in rural areas, where most health institutions do not have trained staff. Private mental health clinics are unaffordable for the poor, placing a heavy financial burden on families seeking care for loved ones.
LEADS' Mental Health Camps: Providing Essential Care and Promoting Awareness in Rural Nepal
In the past nine months, LEADS has organized six mental health camps in two districts. These camps are conducted by a medical team from the Western Regional Hospital under an agreement with the head of the psychiatry department.
What are the goals of the Mental Health Camps?
- Provide free, specialized treatment and support for individuals with mental illness.
- Help district hospitals become recognized for mental health services.
- Reduce stigma and increase public understanding of mental health.
- Encourage people with mental illnesses and their carers to participate in service development.
- Ensure rural health facilities have enough services to support patients.
- Promote mental health prevention efforts by the government.
Identifying and Supporting People with Mental Illness in Rural Communities
LEADS sends social mobilizers to visit homes and inform families about mental health, raising awareness and the District Public Health Officer sends a letter to health post staff, asking them to invite local leaders, volunteers, and community groups.
After this, LEADS organizes meetings at village health posts, where 35-50 people attend, and the meetings last 3-4 hours to identify people with mental illnesses. Following the meetings, individuals with mental health issues and their carers are invited to attend the Mental Health Camp at the district hospital, where many learn about it from volunteers and health staff.
Challenges in Expanding Mental Health Camp Access and Integrating Services into the Government System
As awareness of mental health spread through health posts, volunteers, and media, more people attended the mental health camps, showing high demand for services. However, organizing monthly camps became difficult due to limited psychiatrists and high costs.
The western region has only two government psychiatrists, both working in private practice. While hospitals like Manipal Teaching Hospital are willing to help at a lower cost, they require registration in their system. LEADS focuses on integrating mental health into the government system, and government participation is crucial. Positive changes in the Health Management Information System are helping prioritize mental health in the region.
Overview of the Mental Health Camp Process
The bi-monthly camp is led by a senior psychiatrist with hospital support. New patients are registered into the government system, and those with other health issues are referred accordingly. The camp is divided into three sections:
- Registration Unit: Staff register new and returning patients, collect baseline information, and guide them to the next unit.
- Examination Unit: A psychiatrist and a senior health assistant conduct check-ups, with the assistant performing basic health checks before referral to the psychiatrist for diagnosis and prescription.
- Pharmacy Unit: Staff distribute pre-packaged medicines with dosage instructions, prepared in advance in Pokhara.
Patients receive a one-month supply and are advised to visit their nearest health facility for follow-up and additional medications the next month.
The Importance and Benefits of FOLLOW-UP CLINICS in mental health care
Follow-up clinics are essential in preventing complications and side effects, adjusting treatment as needed, tracking recovery, and assessing the financial and social situations of patients.
These clinics offer several benefits, including immediate guidance from psychiatrists, cost-effective and accessible services, and opportunities for skill development for health workers.
They also help increase mental health awareness, promote the integration of mental health services into the government system, and influence policy.
Additionally, follow-up clinics provide evidence-based advocacy for better mental health policies, ensuring a more effective and inclusive approach to mental health care.
Using MOBILE PHONES for mental health follow-up clinics
The growing demand for mental health services in Baglung and Myagdi districts has highlighted the need for sustainable follow-up care. By the third quarter, 245 individuals were receiving treatment at Mental Health camps, with 52% from rural areas. This surge in demand strained resources, affecting service quality and timeliness.
To address this, LEADS organized follow-up clinics at rural health institutions, staffed by trained personnel. However, the involvement of a psychiatrist was crucial for accurate diagnoses. Given the shortage of psychiatrists and challenges with remote visits, LEADS introduced mobile phone consultations as a cost-effective, practical solution. This approach enables rural health workers to consult psychiatrists remotely, ensuring continuous, high-quality care.
The initiative represents a significant step forward in overcoming geographical and professional barriers, offering a scalable, cost-effective model for expanding mental health services across Nepal.
Our Programs in Action
The leads Nepal Model to Integrate Mental Health and Development in Rural Nepal
Mental health is often neglected when considering overall well-being, especially in rural areas and among socially disadvantaged communities. In Nepal, limited access to mental health services leaves vulnerable individuals at a greater risk of developing mental illnesses. To address the challenges these communities face, it is essential to integrate mental health support into broader development strategies. This is the reason why LEADS has designed a model that integrates mental health care with community development, addressing both individual needs and broader social challenges. The direct link between poverty and mental health People living in socially disadvantaged conditions, including those in rural Nepal, are particularly susceptible to mental health issues. The stress of poverty, limited access to education, unemployment, and stigma often exacerbates the challenges of mental illness. The World Health Organization (WHO) highlights the importance of targeted development strategies to support individuals with mental health conditions, who often live in poverty. Addressing this overlap between mental health and socio-economic disadvantage requires a comprehensive approach that considers both medical and social factors. The LEADS Nepal model: empowering communities through integrated mental health care Established in 2009, the LEADS Nepal Model is a pioneering community-based approach that integrates mental health services into development programs, empowering communities and strengthening local health systems. The model operates on the principle that local empowerment is key. By involving trained local stakeholders, such as health workers and community members, LEADS Nepal helps identify individuals in need of mental health care, facilitating access to services that might otherwise be out of reach. This model aims to break down the barriers of stigma, cost, and geographical isolation that often prevent rural populations from seeking treatment. The LEADS Nepal approach to providing accessible mental health care in remote areas The LEADS Nepal program operates primarily in the Baglung and Myagdi districts, areas where agriculture is the main source of livelihood and access to healthcare is limited due to the remote nature of the villages. The program is now extending to Nawalpur district, further expanding its reach to support more communities in need of mental health services. In response to the long travel and high costs of accessing mental health services, LEADS launched the Mental Health Camps (MHC) program in August 2010, bringing mobile clinics to local health posts. These outpatient services reduce travel and expenses, making mental health care more accessible in remote areas. By offering on-site mental health services, LEADS Nepal improves access to treatment while providing continuous support through regular visits and follow-up care. The program combines mental health interventions with community development efforts, ensuring that patients receive comprehensive care that addresses both their medical needs and livelihood support. Outcomes and impact: positive change in communities The impact of the LEADS Nepal Model has been significant. By March 2011, 311 patients had been registered in the program, with 269 showing clinical improvement. This indicates a successful model for treating mental health conditions, even in challenging rural environments. Additionally, the program has significantly reduced travel costs for patients and improved access to essential medications, making treatment more affordable and manageable for families already facing financial difficulties. Beyond medical care, the program also emphasizes livelihood support for individuals with mental health conditions. By providing skills training and business grants, LEADS Nepal has helped many participants generate income, improving their economic standing and enhancing their overall quality of life. This dual approach of addressing both mental health and livelihoods has proven effective in fostering long-term recovery and community resilience. Challenges facing the LEADS Nepal model: logistics and workforce shortages Despite the success of the LEADS Nepal Model, there are challenges to overcome. The remote locations of the villages create significant logistical difficulties, with many areas being difficult to access by road. This makes it challenging to provide consistent and comprehensive care to all who need it, particularly in more isolated communities. Additionally, the demand for mental health services often exceeds the availability of trained personnel and psychiatric support. The shortage of qualified mental health professionals in rural areas continues to be a major barrier to the program's expansion and long-term sustainability. A lasting impact: the success of the LEADS Nepal model in integrating mental health and development LEADS Nepal highlights the potential of integrating mental health services into community development efforts, particularly in rural and underserved areas. Despite facing logistical challenges, the program has demonstrated that a community-based, integrated approach can significantly improve access to mental health care while simultaneously addressing the broader socio-economic issues that many individuals face. By empowering local communities and prioritizing both mental health and livelihoods, the LEADS Nepal Model serves as a valuable example of how mental health can be successfully integrated into development strategies, creating lasting impact in rural Nepal.ng impact in rural Nepal.
CARER COOPERATIVE: Empowering carers and strengthing communities for a sustainable future
Carer Cooperatives are not just financial institutions; they are transformative lifelines for communities, empowering individuals—especially women—to break free from poverty and marginalization. By promoting economic independence, solidarity, and advocacy, CCs are paving the way for a more inclusive and sustainable future for carers and their families. LEADS Nepal is dedicated to expanding this powerful model, ensuring that no carer is left behind in the journey towards empowerment and opportunity. How do Carer Cooperatives empower individuals and strengthen communities? They empower individuals and strengthen communities through a holistic approach that addresses both economic and social needs. 1. Economic Empowerment: Offering carers opportunities for Income Generating Activities, fostering financial independence, and reducing stigma, particularly for women. 2. Training & Capacity Building: Providing essential skills in governance, financial management, and advocacy to help carers manage cooperatives and advocate for their rights. 3. Access to Resources: Facilitating revolving funds and connections to government schemes and microfinance, supporting carers in sustaining income-generating activities. 4. Networking & Advocacy: Empowering cooperatives to engage with local governments, advocating for carers' needs and promoting mental health and socio-economic security. What's the impact of Cooperatives? Cooperatives have a significant impact on individuals and communities by driving positive change in various ways: Financial Empowerment by encouraging saving habits and fostering participation in income generating activities, Cooperatives help reduce poverty and build long-term financial stability. Women’s Inclusion with 71% of female members benefiting from these programs, cooperatives enable women to achieve financial independence and security, helping to bridge gender gaps in economic participation. Advocacy and Solidarity enable cooperatives to amplify carers' voices, ensuring their concerns are reflected in local development agendas and government programs that promote their rights and needs. Economic security is achieved by supporting carers in establishing sustainable livelihoods, with cooperatives fostering community and collective strength to create a more secure future for members and their families. LEADS Nepal's Cooperatives and their impact LEADS established two cooperatives in the districts of Baglung and Myagdi in 2016, and a new cooperative is currently being set up in the district of Nawalpur. Through these cooperatives: 195 active savings accounts have been established in Baglung, and 210 in Myagdi, promoting financial responsibility and creating new economic opportunities. 1,165 carers have received microloans ranging from NPR 20,000 to NPR 100,000, enabling them to launch and sustain income-generating activities. These savings accounts and microloans have had a remarkable impact, not only empowering carers but also driving economic growth. Additionally, the Carers Agri-Product Business, a registered entity in Kathmandu, has been established to help collectively brand and market the products made by carers, allowing them to reach larger markets and maximize their economic impact. Sustainability and empowerment of Carer Cooperatives The sustainability of the cooperatives is rooted in their formal registration, which provides carers with a recognized platform to engage with local governments and stakeholders. LEADS Nepal focuses on building the capacity of carers, preparing them for long-term self-reliance and effective advocacy. The ultimate goal is for these cooperatives to operate independently, with the skills and resources needed to thrive without ongoing support from LEADS. Future goals for Carer Cooperatives The project aims to expand and connect district-level carer cooperatives into regional cooperatives, amplifying their collective influence and bargaining power. It also seeks to broaden inclusion by establishing new cooperatives in targeted districts, with a focus on women and marginalized groups. Additionally, the project will enhance advocacy by using CCs as platforms to advance carers' rights and achieve long-term financial independence. LEADS Nepal is committed to expanding this transformative model, ensuring that carers are recognized, supported, and empowered for a sustainable future.
LEADS' pioneering Mental Health Camps and mobile-enabled Follow-up Clinics in Rural Nepal
LEADS Nepal, in partnership with BasicNeeds UK, has been running a mental health and development program in Baglung and Myagdi districts since April 2010. The program helps people with mental illnesses and epilepsy recover and supports their families with livelihood opportunities. LEADS works closely with government health institutions to train health workers, improve mental health services, and influence policies. It also advocates for better access to mental health medicines and aims to integrate mental health care into rural health facilities. Through trained health workers and volunteers, the program raises awareness and ensures communities receive the support they need. Mental Health Challenges in Rural Nepal: The Impact of Poverty, Violence, and Gender Discrimination People in the program area face a high risk of mental illness due to poverty, violence, past conflict, and substance abuse. Hill districts have high suicide rates and many mental health problems, but the nearest mental health service is in Pokhara. Those with mental illnesses often face stigma and exclusion from family and community life. In severe cases, they may be locked up, violating their rights. Mental illness also creates challenges for employment—both for the affected person and their carers. Women, especially poor and marginalized ones, are more vulnerable due to gender discrimination. They have fewer rights, lower literacy, and face high levels of gender-based violence, which is worse for those with mental illnesses. Challenges in Mental Health Services in Nepal: Limited Access, Resources, and Expertise In Nepal, access to mental health care is severely limited, particularly in rural areas. Local health posts lack mental health drugs, and district hospitals have only a limited supply. There's no emergency mental health plan in place, unlike the emergency protocols for general health, and many healthcare workers cannot prescribe psychotropic medicines due to strict regulations. Nepal also suffers from a significant shortage of mental health professionals. The country has only 0.59 mental health professionals per 100,000 people, including 32 psychiatrists, 16 general doctors, 68 nurses, and 6 psychologists. There are no social workers or occupational therapists. The sole mental hospital in Kathmandu has just 50 beds and primarily serves low- and middle-income patients, with 750-800 inpatients and 23,000 outpatients annually. A critical issue is the lack of government mental health services in rural areas, where most health institutions do not have trained staff. Private mental health clinics are unaffordable for the poor, placing a heavy financial burden on families seeking care for loved ones. LEADS' Mental Health Camps: Providing Essential Care and Promoting Awareness in Rural Nepal In the past nine months, LEADS has organized six mental health camps in two districts. These camps are conducted by a medical team from the Western Regional Hospital under an agreement with the head of the psychiatry department. What are the goals of the Mental Health Camps? Provide free, specialized treatment and support for individuals with mental illness. Help district hospitals become recognized for mental health services. Reduce stigma and increase public understanding of mental health. Encourage people with mental illnesses and their carers to participate in service development. Ensure rural health facilities have enough services to support patients. Promote mental health prevention efforts by the government. Identifying and Supporting People with Mental Illness in Rural Communities LEADS sends social mobilizers to visit homes and inform families about mental health, raising awareness and the District Public Health Officer sends a letter to health post staff, asking them to invite local leaders, volunteers, and community groups. After this, LEADS organizes meetings at village health posts, where 35-50 people attend, and the meetings last 3-4 hours to identify people with mental illnesses. Following the meetings, individuals with mental health issues and their carers are invited to attend the Mental Health Camp at the district hospital, where many learn about it from volunteers and health staff. Challenges in Expanding Mental Health Camp Access and Integrating Services into the Government System As awareness of mental health spread through health posts, volunteers, and media, more people attended the mental health camps, showing high demand for services. However, organizing monthly camps became difficult due to limited psychiatrists and high costs. The western region has only two government psychiatrists, both working in private practice. While hospitals like Manipal Teaching Hospital are willing to help at a lower cost, they require registration in their system. LEADS focuses on integrating mental health into the government system, and government participation is crucial. Positive changes in the Health Management Information System are helping prioritize mental health in the region. Overview of the Mental Health Camp Process The bi-monthly camp is led by a senior psychiatrist with hospital support. New patients are registered into the government system, and those with other health issues are referred accordingly. The camp is divided into three sections: Registration Unit: Staff register new and returning patients, collect baseline information, and guide them to the next unit. Examination Unit: A psychiatrist and a senior health assistant conduct check-ups, with the assistant performing basic health checks before referral to the psychiatrist for diagnosis and prescription. Pharmacy Unit: Staff distribute pre-packaged medicines with dosage instructions, prepared in advance in Pokhara. Patients receive a one-month supply and are advised to visit their nearest health facility for follow-up and additional medications the next month. The Importance and Benefits of FOLLOW-UP CLINICS in mental health care Follow-up clinics are essential in preventing complications and side effects, adjusting treatment as needed, tracking recovery, and assessing the financial and social situations of patients. These clinics offer several benefits, including immediate guidance from psychiatrists, cost-effective and accessible services, and opportunities for skill development for health workers. They also help increase mental health awareness, promote the integration of mental health services into the government system, and influence policy. Additionally, follow-up clinics provide evidence-based advocacy for better mental health policies, ensuring a more effective and inclusive approach to mental health care. Using MOBILE PHONES for mental health follow-up clinics The growing demand for mental health services in Baglung and Myagdi districts has highlighted the need for sustainable follow-up care. By the third quarter, 245 individuals were receiving treatment at Mental Health camps, with 52% from rural areas. This surge in demand strained resources, affecting service quality and timeliness. To address this, LEADS organized follow-up clinics at rural health institutions, staffed by trained personnel. However, the involvement of a psychiatrist was crucial for accurate diagnoses. Given the shortage of psychiatrists and challenges with remote visits, LEADS introduced mobile phone consultations as a cost-effective, practical solution. This approach enables rural health workers to consult psychiatrists remotely, ensuring continuous, high-quality care. The initiative represents a significant step forward in overcoming geographical and professional barriers, offering a scalable, cost-effective model for expanding mental health services across Nepal.
583
People
completed vocational training
320
Participants in
capacity- building programs
1,261
Beneficiaries of income generating activities
Our Field Workers
Bindu Devi Sharma
District Field Coordinator, Baglung
Bindu has been working with us for three years. She is responsible for providing overall leadership to the district programmes. The major duty includes facilitating and empowering Carers Cluster Committees, district carer association and district carers cooperative for effective leadership, management, and networking. Her role also includes monitoring and reporting, close coordination with local municipality bodies and government agencies.
Sumitra Shrestha
District Coordinator, Nawalpur
Sumitra is a single mother with her 3 year old son. She has Intermediate level qualification in Management and She is from the local community. Her role involves orientation and raising awareness to local community in mental health and reproductive health issues, identifying local community groups, forming and facilitating Carers groups and work closely with Female Community Health Volunteers and municipality ward level.
Hom Bahadur Thapa
Cooperative Systems Coordinator, Baglung
Hom is highly experienced and expert in cooperative management, cooperative training and perfect in accounting software. After several years work experience with cooperative in Baglung, he has recently joined our LEADS team. He is based in Baglung office, but responsible to train Myagdi and Nawalpur cooperative staff. He will assist Nawalpur team in the process of registration of new carers cooperative in Nawalpur and fully support for further development.
Sunita Pandey
Social Mobilizer, Nawalpur
Sunita is newly trained social mobiliser. She has obtained Intermediate level qualification in education. Her role involves orientation and raising awareness to local community in mental health and reproductive health issues, identifying local community groups, forming and facilitating Carers groups and work closely with Female Community Health Volunteers and municipality ward level.
Esha Saru Magar
Social Mobilizer, Nawalpur
Esha is local, comes from a local Magar ethic community, and speaks local language. She has Intermediate level of qualification in education, newly trained as social mobiliser. Her role involves orientation and raising awareness to local community in mental health and reproductive health issues, identifying local community groups, forming and facilitating Carers groups and work closely with Female Community Health Volunteers and municipality ward level.
Dalimaya Ale
Social Mobilizer, Nawalpur
Dalimaya is local resident in Baudikali Nawalpur she has two years experience as social mobiliser. She has obtained Intermediate level qualification in education. Her role involves orientation and raising awareness to local community in mental health and reproductive health issues, identifying local community groups, forming and facilitating Carers groups and work closely
Shiva Khatri
Cooperative Support Assistant, Myagdi
Shiva is a local resident of Myagdi, son of a Carer, and holds intermediate degree in management. He has one year experience with World Link in the costumer services department. He will be trained in cooperative systems and accounting software. Shiva will maintain cooperative accounting system, field visits for cluster meetings, collect daily deposites, communicate all carers share holders and liaise with district government cooperative office.
TESTIMONIALS: HOW LEADS TRANSFORMED MY LIFE
Gopal Kisan
After years of poverty, loss, and overwhelming challenges, LEADS gave us the strength and hope to rebuild our lives, starting with my wife’s recovery and our newfound stability.
I am Gopal Kisan, a 47-year-old father of four from a small village. My life was marked by poverty and social discrimination, worsened when my brother-in-law, a school headmaster, was killed by Maoists. His death deeply affected my wife, Dhan Kumari Sarki, who developed bipolar disorder. Caring for her and four children was overwhelming. My daughter’s engagement was canceled, and the others had to drop out of school.
Then a LEADS social mobilizer introduced me to free mental health treatment. My wife’s recovery through counseling and medication was life changing. She’s now thriving—raising chickens and goats, doing household work, and participating in community activities.
LEADS also supported our livelihoods. I was elected chairperson, received goats and chickens to start a business, and earned over 290,000 NPR in the first year. I also started a furniture business, and our lives began to improve.
Today, I can see the light at the end of the tunnel, and I’m determined to help bring change to my village. LEADS has been key in transforming our lives, and I am proud of how far we've come. My elder daughter is now married and recently had a baby boy, while our two sons have joined the furniture workshop. Our youngest daughter just flew to Japan on a scholarship program.
Dhan Kumari and I are deeply grateful. She says, "Please convey our heartfelt thanks to the donors who gave us back our hope."
Juna Harijan
Every day is a battle, but my son’s dreams and the strength I’ve gained from LEADS fuel my determination to overcome the odds and create a better life for my family.
My name is Juna Harijan, and I am a 32-year-old mother from Baglung. Life has been incredibly challenging for my family. My husband’s kidneys failed, and last year, I donated one of mine to give him a chance at recovery. Sadly, his health remains fragile, and he is unable to work or contribute to our income.
As the sole provider for our family, I’ve had to take on labor work to make ends meet. Alongside these struggles, I am raising my 13-year-old son, who is studying in class 5 and is my greatest motivation to keep pushing forward despite the odds.
Things began to change when I joined the cooperative in Baglung, supported by LEADS Nepal. They provided me with two goats and 15 chickens, and I’ve since started raising a buffalo as well. These animals have become a lifeline, offering a steady source of income to support my family. However, I’ve gained more than just financial help—I’ve found hope and the strength to envision a better future. I’ve already repaid some of my debts and plan to expand my goat and chicken farming, eventually applying for a larger loan to improve our livelihood even further.
Each day brings its own challenges, but I remain determined. My son is my inspiration, and through hard work, the support of the cooperative, and the encouragement I’ve received from LEADS Nepal, I am confident I can create a better life for my family and myself.
Sunita Nepali
After losing my husband to mental illness and being landless, I found the strength to keep going through the support of LEADS Nepal, who gave me a community and the means to care for my children.
I am Sunita Nepali, a woman from Baglung and an active member of LEADS Nepal’s local cooperative. My husband struggled with mental illness for many years, and his condition made it impossible for him to work or support us. Last year, we lost him, and the weight of that loss has been incredibly difficult to bear.
I am landless, and the only source of income I have is the labor work I do. Every day, I work tirelessly, doing whatever I can to provide for my family. My two children, Sirisha and Sirish, are my biggest motivation. Sirisha, my 14-year-old daughter, is in class eight, and Sirish, my 11-year-old son, is in class three at the local government school. Despite our struggles, I am determined to give them an education and a better future.
Being a part of the cooperative, supported by LEADS Nepal, has helped me in many ways. It has provided me with not only financial support but also a sense of community. It’s a place where I can share my experiences and learn from others who face similar challenges. Through LEADS, I have gained the strength to keep pushing forward, knowing that with hard work and dedication, I can help my children achieve a better future. Their education is my greatest priority, and I will continue to do everything in my power to ensure they have the opportunities they deserve.
Tulasi
At 69, with the support of LEADS Nepal, I’ve transformed from a man once isolated by stigma to an advocate for carers and mental health, determined to create lasting change for those who face similar challenges.
I am Tulsi, and my life has been defined by resilience, sacrifice, and an unwavering commitment to my family. I live with my wife, Herikala, and my 39-year-old daughter-in-law, Tika. Twenty years ago, my son abandoned Tika and their unborn child, and her mental health began to deteriorate immediately. Heartbroken and overwhelmed, Tika’s condition worsened, and I took her to see a psychiatrist, who diagnosed bipolar disorder and prescribed medication, which became crucial for her recovery.
Despite our limited income, I took on the responsibility for her treatment. Through LEADS Nepal, Tika received additional support, and we improved our vegetable farming to cover her medical expenses. Over time, our hard work allowed us to sustain ourselves and repay old debts. Today, Tika’s daughter is studying engineering in Kathmandu, and I have secured funds to support her education.
But my commitment goes beyond just providing for my family. At 69, I am driven by a passion to advocate for carers and individuals with mental health conditions. I joined a carers’ group through LEADS Nepal, where I find strength and support. I once faced stigma and isolation in my community, but now, I find joy in caring for Tika, believing that “if a person does not care for others, he is not a person.”
Looking ahead, I worry about Tika’s future when I’m gone, so I plan to transfer our home and land to her. I dream of systemic change, advocating for carers and mental health issues, hoping to one day speak to the president about the need for better support.
My journey has been one of love, resilience, and hope, and I hope my story inspires others to never give up.
Sarita Pariyar
From the depths of despair, caring for my disabled husband and two children, LEADS gave me the tools to transform my life, helping me find purpose and strength in a community of support.
I am Sarita, Chairperson of the Carers Association in Baglung and an executive member of the Carers Cooperative, but my life was not always this way.
My husband went to India for work just after we married, and two years later, he returned home badly injured. He fell from a train track and broke his back, spending the rest of his life in a wheelchair. He also struggled with mental illness, which made it impossible for him to work. With two children to care for, I had limited options and struggled to support my family.
Then LEADS came into our lives. They gave me goats and later provided training in making paper ornaments. I joined a self-help group and became the chairperson. I started selling the ornaments made by our group, and my husband, even in his condition, learned the craft and began making ornaments and bangles as well.
Thanks to LEADS, I gained confidence and began to feel respected in my community. I was even anonymously elected Chairperson of the Carers Association at the district level. Life started to change.
My son, Binayak, refused to go to India like many other boys from our village. Instead, he chose to stay and study. He continues his 12th grade education at the local school, working on the farm and caring for the goats and chickens. Though education is difficult for poor families in the village, I am doing my best to support him.
My husband passed away last year at the age of 41, but the changes LEADS helped bring into our lives have made all the difference. I am now more confident, respected, and hopeful for the future, especially for my son.
TESTIMONIES: HOW LEADS TRANSFORMED MY LIFE
Gopal Kisan
"After years of poverty, loss, and overwhelming challenges, LEADS gave us the strength and hope to rebuild our lives, starting with my wife’s recovery and our newfound stability."
I am Gopal Kisan, a 47-year-old father of four from a small village. My life was marked by poverty and social discrimination, worsened when my brother-in-law, a school headmaster, was killed by Maoists. His death deeply affected my wife, Dhan Kumari Sarki, who developed bipolar disorder. Caring for her and four children was overwhelming. My daughter’s engagement was canceled, and the others had to drop out of school.
Then a LEADS social mobilizer introduced me to free mental health treatment. My wife’s recovery through counseling and medication was life changing. She’s now thriving—raising chickens and goats, doing household work, and participating in community activities.
LEADS also supported our livelihoods. I was elected chairperson, received goats and chickens to start a business, and earned over 290,000 NPR in the first year. I also started a furniture business, and our lives began to improve.
Today, I can see the light at the end of the tunnel, and I’m determined to help bring change to my village. LEADS has been key in transforming our lives, and I am proud of how far we've come. My elder daughter is now married and recently had a baby boy, while our two sons have joined the furniture workshop. Our youngest daughter just flew to Japan on a scholarship program.
Dhan Kumari and I are deeply grateful. She says, "Please convey our heartfelt thanks to the donors who gave us back our hope."
Juna Harijan
"Every day is a battle, but my son’s dreams and the strength I’ve gained from LEADS fuel my determination to overcome the odds and create a better life for my family."
My name is Juna Harijan, and I am a 32-year-old mother from Baglung. Life has been incredibly challenging for my family. My husband’s kidneys failed, and last year, I donated one of mine to give him a chance at recovery. Sadly, his health remains fragile, and he is unable to work or contribute to our income.
As the sole provider for our family, I’ve had to take on labor work to make ends meet. Alongside these struggles, I am raising my 13-year-old son, who is studying in class 5 and is my greatest motivation to keep pushing forward despite the odds.
Things began to change when I joined the cooperative in Baglung, supported by LEADS Nepal. They provided me with two goats and 15 chickens, and I’ve since started raising a buffalo as well. These animals have become a lifeline, offering a steady source of income to support my family. However, I’ve gained more than just financial help—I’ve found hope and the strength to envision a better future. I’ve already repaid some of my debts and plan to expand my goat and chicken farming, eventually applying for a larger loan to improve our livelihood even further.
Each day brings its own challenges, but I remain determined. My son is my inspiration, and through hard work, the support of the cooperative, and the encouragement I’ve received from LEADS Nepal, I am confident I can create a better life for my family and myself.
Sunita Nepali
"After losing my husband to mental illness and being landless, I found the strength to keep going through the support of LEADS Nepal, who gave me a community and the means to care for my children."
I am Sunita Nepali, a woman from Baglung and an active member of LEADS Nepal’s local cooperative. My husband struggled with mental illness for many years, and his condition made it impossible for him to work or support us. Last year, we lost him, and the weight of that loss has been incredibly difficult to bear.
I am landless, and the only source of income I have is the labor work I do. Every day, I work tirelessly, doing whatever I can to provide for my family. My two children, Sirisha and Sirish, are my biggest motivation. Sirisha, my 14-year-old daughter, is in class eight, and Sirish, my 11-year-old son, is in class three at the local government school. Despite our struggles, I am determined to give them an education and a better future.
Being a part of the cooperative, supported by LEADS Nepal, has helped me in many ways. It has provided me with not only financial support but also a sense of community. It’s a place where I can share my experiences and learn from others who face similar challenges. Through LEADS, I have gained the strength to keep pushing forward, knowing that with hard work and dedication, I can help my children achieve a better future. Their education is my greatest priority, and I will continue to do everything in my power to ensure they have the opportunities they deserve.
Tulasi
"At 69, with the support of LEADS Nepal, I’ve transformed from a man once isolated by stigma to an advocate for carers and mental health, determined to create lasting change for those who face similar challenges."
I am Tulsi, and my life has been defined by resilience, sacrifice, and an unwavering commitment to my family. I live with my wife, Herikala, and my 39-year-old daughter-in-law, Tika. Twenty years ago, my son abandoned Tika and their unborn child, and her mental health began to deteriorate immediately. Heartbroken and overwhelmed, Tika’s condition worsened, and I took her to see a psychiatrist, who diagnosed bipolar disorder and prescribed medication, which became crucial for her recovery.
Despite our limited income, I took on the responsibility for her treatment. Through LEADS Nepal, Tika received additional support, and we improved our vegetable farming to cover her medical expenses. Over time, our hard work allowed us to sustain ourselves and repay old debts. Today, Tika’s daughter is studying engineering in Kathmandu, and I have secured funds to support her education.
But my commitment goes beyond just providing for my family. At 69, I am driven by a passion to advocate for carers and individuals with mental health conditions. I joined a carers’ group through LEADS Nepal, where I find strength and support. I once faced stigma and isolation in my community, but now, I find joy in caring for Tika, believing that “if a person does not care for others, he is not a person.”
Looking ahead, I worry about Tika’s future when I’m gone, so I plan to transfer our home and land to her. I dream of systemic change, advocating for carers and mental health issues, hoping to one day speak to the president about the need for better support.
My journey has been one of love, resilience, and hope, and I hope my story inspires others to never give up.
Sarita Pariyar
"From the depths of despair, caring for my disabled husband and two children, LEADS gave me the tools to transform my life, helping me find purpose and strength in a community of support."
I am Sarita, Chairperson of the Carers Association in Baglung and an executive member of the Carers Cooperative, but my life was not always this way.
My husband went to India for work just after we married, and two years later, he returned home badly injured. He fell from a train track and broke his back, spending the rest of his life in a wheelchair. He also struggled with mental illness, which made it impossible for him to work. With two children to care for, I had limited options and struggled to support my family.
Then LEADS came into our lives. They gave me goats and later provided training in making paper ornaments. I joined a self-help group and became the chairperson. I started selling the ornaments made by our group, and my husband, even in his condition, learned the craft and began making ornaments and bangles as well.
Thanks to LEADS, I gained confidence and began to feel respected in my community. I was even anonymously elected Chairperson of the Carers Association at the district level. Life started to change.
My son, Binayak, refused to go to India like many other boys from our village. Instead, he chose to stay and study. He continues his 12th grade education at the local school, working on the farm and caring for the goats and chickens. Though education is difficult for poor families in the village, I am doing my best to support him.
My husband passed away last year at the age of 41, but the changes LEADS helped bring into our lives have made all the difference. I am now more confident, respected, and hopeful for the future, especially for my son.