Helping children after the floods: school health nurses supporting mental health

The first batch of school health nurses in Nuwakot participate in the two-day orientation on mental health and psychosocial support (MHPSS) held on 2-3 October.

During her seven years as a school health nurse at Janakalyan Secondary School, Dhading, Rekha Adhikary has mostly treated physical ailments such as headaches, fever, cuts and injuries from falls.

After the 26 August flood, however, some students came to her with a different kind of concern—they were struggling with fear and distress caused by what they had seen and experienced. Although the school itself did not face any loss or damage, 45 of the students were directly affected by the flood.

“The affected children repeatedly want to talk about the flood,” says Adhikary. She has also noticed that many of them have difficulty concentrating in class.

Adhikary was among the participants in the two-day orientation for school health nurses on mental health and psychosocial support (MHPSS), held in Dhading on 8–9 October. The orientation covered practical skills to recognise emotional distress among children and adolescents, offer basic psychosocial support and facilitate referrals to specialised services when needed.  Recognising the needs of school health nurses, some of whom were deployed to holding centres within days of the flood, and some others who were directly affected, the orientation began with a dedicated session on care for caregivers. This session provided an opportunity for participants to strengthen self-care practices, recognise signs of distress and support their own mental health and psychosocial well-being.

School health nurses in Dhading participate in the orientation on mental health and psychosocial support (MHPSS) on 8 October.

The orientation is being conducted under the WHO-supported initiative, “Implementation of School-Based Child Mental Health and Psychosocial Support (MHPSS) in Flood-Affected Areas.”

As of 15 October, 110 participants, including school health nurses, clinical nurses and teachers, had attended the orientation across Nuwakot, Dhading and Chitwan, with future sessions planned for Rasuwa. The participants will continuously be supervised by experts for three months when they implement their skills at their schools.  

Supported by EU Civil Protection & Humanitarian Aid, the programme is being implemented in coordination with the Nursing and Social Security Division (NSSD), the Epidemiology and Disease Control Division (EDCD), the Provincial Health Directorate, district public health offices and local governments, with technical support from WHO. Unity in Health (UiH) is implementing the activities on the ground.

As schools reopen, some children may be coping with fear, grief, displacement or disruption to family and school life. By equipping school health nurses with MHPSS skills, the initiative can help make schools more supportive places for children and adolescents.

“Children and adolescents are more vulnerable during disasters,” says Sagoon KC, a nurse and counsellor with Unity in Health. “If we do not identify and address these challenges early, it can have long-term effects.”

Facilitator and participants during the orientation for school health nurses on Mental Health and Psychosocial Support (MHPSS).

Following the orientation, participating school health nurses say they feel confident in addressing children’s mental health and psychosocial needs. “I feel like I can help them,” says Kabina Thapaliya, a school health nurse at Niranjana Secondary School, who participated in the first batch (2–3 October) in Nuwakot. “I can provide counselling and identify their needs and refer them to appropriate services whenever necessary.”

In Dhading, Adhikary has already made plans for when the school reopens after the Dashain holidays.

“When the school reopened after the floods, we provided counselling to the affected students,” says Adhikary. “But now I know it wasn’t enough.” She plans to follow up with the students and check on their condition. She also wants to use the activities and breathing exercises she learned during the orientation to help the affected students.

Apart from strengthening participants’ capacity to support children and adolescents, the orientation also emphasized the importance of maintaining their own mental health and psychosocial well-being.

Sagoon KC of Unity in Health facilitates the session on care for caregivers.

“While helping the children, we often forget about ourselves,” says Adhikary. “The session on caring for caregivers reminded me that my own mental health is also important. Only by taking care of myself can I continue to help others.”

Alongside self-care, school health nurses also need opportunities to rest, supportive supervision and access to appropriate support.

As part of its broader support, WHO is working with the Government of Nepal to strengthen mental health and psychosocial support for flood-affected communities.