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Mental Health and Cognitive Status Among Adolescent Students in Kathmandu

HNN Staff by HNN Staff
May 25, 2025
in Articles, English
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Illustration Mental Health and Cognitive Status Among Adolescent Students in Kathmandu

Illustration Mental Health and Cognitive Status Among Adolescent Students in Kathmandu

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Upendra Raj Dhakal Public Health Professional on Mental Health in Kathmandu

In the heart of Nepal, Kathmandu as an alive city with tradition, learning, and the restless energy of youth. Its amazing with busy streets and timeless temples and busy with different activities, where many teenagers – students balancing school demands, friendships, and their own evolving identities – shape the city’s rhythm. However, beneath the surface of this dynamic city lies a growing concern: the mental health and cognitive well-being of adolescent students. Emerging research and firsthand accounts shed light on the difficulties encountered by young people, such as emotional strain, mental distress, depressive tendencies, and cognitive struggles. These issues can significantly influence their educational achievements and general well-being. This article explores the state of mental health and cognitive status among adolescent students in Kathmandu, highlighting research gap and local insights to shed light on this critical issue.

Kathmandu, a city rich in tradition and youthful energy, faces a growing concern—adolescent mental health and cognitive well-being. Recent studies and firsthand accounts reveal high levels of emotional distress, depression, and cognitive struggles among students, affecting their academic performance and overall well-being.

The Mental Health Landscape for Adolescents in Kathmandu

Adolescence is a transitional stage of development marked by biological, psychological, and social changes that can make young individuals particularly vulnerable to mental health challenges. In Kathmandu, these challenges are unique socio-cultural and environmental factors, such as urban overcrowding, academic competition, and limited access to mental health resources. A study carried out in Dhulikhel, a town near Kathmandu, revealed that 33.3% of school-going adolescents faced psychosocial challenges, as evaluated through the Pediatric Symptom Checklist-Youth Report (Y-PSC). This significant prevalence highlights the pressing need to prioritize adolescent mental health support, particularly in urban areas such as Kathmandu.

The study involved 513 students from grades 8 to 12 in Dhulikhel, revealing that factors such as academic pressure, family dynamics, and peer relationships significantly contribute to psychosocial distress. While Dhulikhel is not Kathmandu, its proximity and similar urban characteristics suggest comparable trends in the capital. Adolescents in Kathmandu face intense academic expectations, with the pressure to excel in national examinations like the Secondary Education Examination (SEE) driving stress and anxiety. Additionally, the rapid urbanization of Kathmandu has led to social isolation for some students, as extended families give way to nuclear households, reducing traditional support systems.

Cognitive Status and Academic Performance

When Cognitive functioning, encompassing attention, memory, and problem-solving skills, is considered during study, it is closely linked to mental health. Chronic stress and mental health disorders can impair cognitive processes, affecting academic outcomes. A study examining perceived stress and coping strategies among undergraduate students in Kathmandu Metropolitan City during the COVID-19 pandemic found that 80% of participants reported moderate to high levels of stress, which negatively impacted their cognitive abilities, such as concentration and memory retention. The study, conducted among 400 management students, highlighted that stress was exacerbated by social isolation, fear of infection, and disruptions to academic routines.

The cognitive impact of mental health challenges is particularly concerning for adolescent students, as this period is critical for brain development. Research indicates that chronic stress often changes neural pathways, reducing cognitive flexibility that can impaire executive functions. In Kathmandu, where students often juggle rigorous academic schedules with extracurricular demands, the cumulative effect of stress can lead to burnout, further compromising cognitive performance. Teachers in Kathmandu’s schools have reported observing difficulties in students’ focus and retention, particularly post-COVID, as the pandemic disrupted regular schooling and increased reliance on virtual learning, which many students found less engaging.

Socio-Cultural and Environmental Influences

Kathmandu’s unique socio-cultural context shapes the mental health and cognitive experiences of its adolescent students. Nepal’s collectivist culture emphasizes family and community, but rapid modernization has strained these traditional structures. Adolescents often face conflicting expectations: to uphold familial duties while pursuing individual ambitions in a competitive academic environment. This tension can contribute to feelings of guilt, anxiety, and low self-worth, as noted in studies on adolescent mental health in Nepal.

Environmental factors also play a role. Kathmandu’s air pollution, traffic congestion, and overcrowded living conditions create a stressful urban environment. Various studies shows the cognitive decline associated with air pollution. Particulate Matter (PM) in between 2 – 5 exposure has found IQ loss in children revealing that non verbal intelligence (Performance IQ) is particularly affected leading to attention deficit and problem solving skills. For students in Kathmandu, prolonged exposure to poor air quality on the way to and at school or in poorly ventilated classrooms may exacerbate cognitive challenges, creating the effects of mental health issues.

Coping Strategies and Interventions

Despite these challenges, adolescent students in Kathmandu employ various coping strategies to manage stress and maintain mental well-being. The study done in students of Kathmandu metropolitian City during COVID – 19 had found that positive coping mechanisms, such as seeking social support, engaging in physical exercise, and practicing cognitive acceptance, were associated with lower stress levels. However, some students resorted to negative coping strategies, such as avoidance or excessive social media use, which were linked to higher stress and poorer mental health outcomes.

School-based interventions have been found strong in addressing mental health issues. A review of mental health interventions done in India in 2022 shares cultural and systemic similarities with Nepal, had found that school-based programs focusing on life skills, coping skills, and resilience curricula significantly improved depressive symptoms, academic stress, and cognitive abilities. In Kathmandu, organizations like the Transcultural Psychosocial Organization (TPO) Nepal have implemented school-based mental health programs, training teachers to identify signs of distress and provide basic counseling. However, such initiatives are limited in scale and reach, particularly in public schools, which serve a large proportion of Kathmandu’s students.

The lack of mental health professionals in Nepal is a significant barrier. With only 0.36 psychiatrists per 100,000 people, access to specialized care is severely restricted, according to the study done in Kathmandu in 2018. Community-based interventions, such as peer support groups and awareness campaigns, are critical to filling this gap. Local NGOs in Kathmandu have begun organizing workshops to destigmatize mental health issues and encourage students to seek help, but cultural stigmas around mental illness remain a challenge.

The Role of Policy and Community Action

Nepal’s mental health policy, drafted in 1997, has yet to be fully implemented, leaving a fragmented system for addressing adolescent mental health. The government had taken steps to integrate mental health into primary healthcare, and now it has been said to integrate mental health in all sections in local level government, but child and adolescent-specific services remain scarce. In Kathmandu, the sole child and adolescent psychiatric unit at Kanti Children’s Hospital is overwhelmed, serving a population of millions. Policymakers must prioritize funding for mental health infrastructure, including training more professionals and expanding school-based programs.

Community action is equally vital. Parents, teachers, and local leaders in Kathmandu can play important role in creating supportive environments for students. Schools can incorporate mental health education into curricula, teaching students about stress management and emotional regulation. Community centers can offer safe spaces for adolescents to connect and share experiences, reducing social isolation.

Conclusion

The mental health and cognitive status of adolescent students in Kathmandu are emerging public health concerns that demand immediate attention. High levels of stress, anxiety, and psychosocial problems, confounded with cognitive impairments from environmental and academic pressures, threaten the well-being and future potential of the city’s youth. While positive coping strategies and school-based interventions offer hope, systemic challenges, including limited resources and cultural stigmas, hinder progress. By investing in mental health infrastructure, promoting community-based support, and opening conversations about mental well-being, Kathmandu can structure the way for a healthier, more responsive generation of students.

References

Thapa, A., Karki, R., & Kaphle, M. (2023). Self-perceived stress and coping strategies during COVID-19 pandemic among the students of Kathmandu Metropolitan City. Journal of Mental Health Disorders, 3(1), 6–15. https://doi.org/10.33696/mentalhealth.3.016

Mehra, D., Lakiang, T., Kathuria, N., Kumar, M., Mehra, S., & Sharma, S. (2022). Mental health interventions among adolescents in India: A scoping review. Healthcare, 10(2), 337. https://doi.org/10.3390/healthcare10020337

McEwen, B. S. (2017). Neurobiological and systemic effects of chronic stress in animals and humans. Annual Review of Psychology, 68, 411-436. https://doi.org/10.1146/annurev-psych-010416-044021

Alter, N.C., Whitman, E.M., Bellinger, D.C. et al. Quantifying the association between PM2.5 air pollution and IQ loss in children: a systematic review and meta-analysis. Environ Health 23, 101 (2024). https://doi.org/10.1186/s12940-024-01122-x

Rijal, A. (2018). Mental health situation in Nepal and priorities for interventions. ResearchGate. Retrieved from https://www.researchgate.net/publication/325112345_Mental_Health_situation_in_Nepal_and_priorities_for_interventions

Shrestha B, Gautam S, Shrestha J, Shrestha S. Psychosocial Problems among the Adolescent School Students of Dhulikhel Municipality. Kathmandu Univ
Med J.
2021;75(3):366-70

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