Bhutan’s health ministry, PEMA secretariat expand mental health access

THIMPHU – With the growing concerns over mental health challenges, Health Minister Tandin Wangchuk acknowledged the scale of the issue during a Meet-the-Press session on July 4, highlighting an encouraging shift in public attitude as more Bhutanese now seek help rather than suffer in silence.

At the heart of the country’s comprehensive response is the PEMA Secretariat, a dedicated nodal agency established under the leadership of Her Majesty the Gyaltsuen.

Tasked with overseeing and coordinating mental health services nationwide, the Secretariat is adopting a whole-of-society approach, recognising that mental health is influenced by multiple, interconnected factors.

In a partnership with the health ministry, the PEMA Secretariat is actively working to embed mental health services at every level of the country’s healthcare system-primary, secondary, and tertiary care.

At the primary healthcare level, Lyonpo said that health workers are undergoing training using a revised Community-Based Mental Health Care Manual. This updated training focuses on mental health promotion, prevention, early identification, basic care, and clear referral pathways.

He also added that, to enhance capacity, some health workers have undergone specialised training at India’s National Institute of Mental Health and Neuro Sciences (NIMHANS).

A Memorandum of Understanding between the PEMA Secretariat and NIMHANS is soon to be formalised to support long-term collaboration and knowledge exchange.

Lyonpo also said that the ministry is also actively working to decentralise specialised services to expand mental health access beyond the capital. Currently, clinical counselors are present in only a few districts, and all psychiatrists are based in Thimphu.

To address this disparity, Lyonpo shared plans to post one psychiatrist to the Central Regional Referral Hospital by the end of 2025, with another expected at the Eastern Regional Referral Hospital the following year.

At the district hospital level, he added that doctors are receiving training, and clinical counselors are being recruited to manage referrals from local health centers.

There are currently 26 counselors in service across hospitals, helplines, and the Gyalsung academies. More than 25 students are now pursuing undergraduate studies in counseling at the Faculty of Nursing and Public Health, with plans for their deployment in the 13th Plan.

In addition, the Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB) has launched a new course to train Community Mental Health Outreach Workers. Its first cohort has already graduated and been deployed.

These workers will play a crucial role in supporting outreach programmes, assisting counselors, and facilitating aftercare services, Lyonpo said.

At the tertiary level, Lyonpo said that seven national psychiatrists are currently stationed at the National Referral Hospital.

With the upcoming 60-bed PEMA Centre poised to open, at least six to seven additional psychiatrists will be required to meet its expanded service capacity.

Two more psychiatrists are currently undergoing training at KGUMSB, and the government is actively exploring options for sub-specialisations to meet emerging national mental health needs.

For those without immediate physical access to care, Lyonpo said that tele-counseling services are being offered via PEMA Helpline Services. Trained counselors provide both online and walk-in support, with the helpline coordinating closely with hospital-based teams to ensure proper referral and follow-up for individuals in need.

Affirming the ministry’s continued commitment, Lyonpo said, “The collaborative efforts between the ministry and the PEMA Secretariat have significantly improved mental health services, with numerous ongoing efforts underway. Let us continue to break the stigma, reach out, seek support, and never suffer in silence.”