She was at a loss for words when doctors at Nepal Mental Hospital said it was the last chance for her husband to make a choice between life and alcohol.

Her husband needed immediate in-patient care.

Doctors said the man suffered from alcohol dependence syndrome, a serious mental health problem in which patients become psychologically and physically dependent on alcohol.

“But I was told the hospital could not accommodate him,” Bimala, who wished to be identified by her first name only, told the Post on Wednesday morning.

Nepal Mental Hospital, the central level hospital for mental health problems, is almost always crowded. It has only 50 beds, and families of the patients from across the country in need of immediate admission are mostly in the situation Bimala was on Wednesday.

Bimala pleaded before the doctors if they could arrange a bed for her husband, to no avail.

Dr Ananta Prasad Adhikari, a consultant psychiatrist at the hospital, who examined her husband, asked a resident doctor if Bimala’s husband could be accommodated. The discharge list showed all beds were occupied until Friday.

Bimala was left with two options—either she had to go to a private hospital or hotel or return home. But none would work for her.

“I cannot afford private hospital expenses. Nor do I have enough money for the hotel,” she said. “It’s difficult to control him if I take him back to my village in Kavrepalanchok.”

Adhikari said for patients like Bimala’s husband, the situation is really difficult in Nepal.

“We have asked the government to upgrade the hospital and increase the number of beds to 300, but it has not happened,” Adhikari told the Post.

On Wednesday alone, there were three patients waiting at the hospital’s emergency ward who were in need of immediate in-patient care.

Doctors say the country is still slow to recognise mental health issues and that the state had made negligible efforts to address such patients’ woes.

Most of the hospitals throughout the country do not have mental health services.

A national Mental Health Survey carried out last year showed that the current prevalence of any form of mental disorder was 12.9 (11.2 percent among 13-17-year-olds and 13.2 percent above 17-year-olds respectively).

The study was carried out among 1,647 participants (1,371 adults above 17 years and 276 adolescents aged 13-17 years) in Dhanusha, Bhaktapur and Dolakha, one from each ecological region.

The study shows that with any form of mental disorder, only 18 percent received treatment in the last 12 months. The study shows a rise in the number of people with mental health conditions, but for patients like Bimala’s husband, who come from humble backgrounds, things are not easy.

“I have to work in neighbours’ fields to feed my family of four—son, daughter, husband and myself,” she told the Post. “I don’t know what I am going to do.”