Addiction, Global Mental Health Are Passions of Young Psychiatrist From Nepal
Abstract
Although Mona Thapa, M.D., had heard about human trafficking in her native Nepal, it was her experience with a victim of the practice in Washington, D.C., that ignited her interest.
Early-career psychiatrist and APA Diversity Leadership Fellow Mona Thapa, M.D., had much to be grateful for while growing up in Kathmandu, Nepal.
Mona Thapa, M.D.: “I was interested in addiction psychiatry even before coming to the U.S. While living in Kathmandu, Nepal, I observed various teenagers falling into drug addiction.”
“My parents placed great emphasis on education and encouraged my brother and me to pursue our professional dreams,” she recalled during a recent interview. “They also urged us to contribute to society to the best of our abilities.”
But there was also a dark side to growing up in Nepal, she admitted.
The Maoist uprising and violence in Nepal during the 1990s filled her with anxiety and insecurity about the future. At the same time, she observed with dismay some teens in her neighborhood succumbing to drug abuse. “It was a nice neighborhood,” she explained, “but drugs were easily accessible. In some sense, it was still part of the ‘hippie trail.’ Forty or 50 years ago, hippies had flocked to Kathmandu because you could buy hashish in shops without any legal consequences.”
Nepal, the small country that’s home to the world’s tallest mountain, gave rise to Mona Thapa, M.D.,’s interest in becoming a psychiatrist. She is now an addiction psychiatry fellow at Yale University School of Medicine.
Thapa also heard about the phenomenon of human trafficking while growing up in Nepal. “Young women were shipped to brothels in other countries, mostly in India, where they were forced to work until they contracted AIDS,” she said. “After that, they were shipped back to Nepal.”
It was only while she was a psychiatry resident at Howard University in Washington, D.C., however, that Thapa had her first contact with a victim of human trafficking. A young woman from Africa was a victim of forced labor and extremely traumatized by her experience. She was rescued by an agency dealing with victims of human trafficking called the Polaris Project and taken to the Howard University Department of Psychiatry for treatment. Thapa treated the young woman for several months.
Both her exposure to youth abusing drugs in Nepal and her experience with this young trafficking victim helped shape her decision to focus on addiction and human trafficking in her psychiatric career, she said.
Human Trafficking Affects Millions
For example, after completing her psychiatry residency at Howard University earlier this year, Thapa started a fellowship in addiction psychiatry at Yale University. As an APA Diversity Leadership Fellow, she also has an opportunity to participate in APA’s Council on Addictions.
She and two other young psychiatrists she met through the Washington Psychiatric Society’s Career, Leadership, and Mentorship (CLM) Program—Veronica Slootsky, M.D., a psychiatry resident at George Washington University, and Milangel Concepcion, M.D., a psychiatry resident at Georgetown University—have attempted to learn more about human trafficking.
“There are almost 27 million men, women, and children around the world who are trafficked each year, studies have found,” said Thapa. “But the numbers are probably much larger because it is a hidden business. There are several interesting things about the phenomenon in the United States. Victims are usually brought from South America. Most are sold for prostitution, others for forced labor—say, domestic help. And there are certain times when prostitution trafficking is prevalent—such as during the Super Bowl.”
“Many victims of human trafficking in the United States suffer from anxiety, depression, or posttraumatic stress disorder,” Thapa said. “Many are here illegally, have no social support, and feel incredibly isolated. The stigma they face is enormous—not just because of their mental illness, but because they have been sold into bondage. And they don’t have access to mental health treatment unless they are fortunate enough to be rescued by an agency such as the Polaris Project. Even if they have access to treatment, an interpreter is usually needed during therapy sessions, and it is often difficult to find interpreters who speak their languages.”
“Veronica, Milangel, and I are planning on working with an agency like the Polaris Project to try to get treatment for victims of human trafficking,” Thapa reported. “We are also attempting to educate medical professionals more about the problem via grand rounds or at meeting poster sessions.”
And still a third passion of hers, Thapa asserted, is global mental health—especially mental health in her native Nepal. This interest, she noted, was ignited by Eliot Sorel, M.D., founder of the CLM Program. Last year, she, along with Slootsky and Concepcion, gave a presentation about global mental health at a World Psychiatric Association congress (Psychiatric News, June 6, 2013).
Opportunities Mixed With Challenges
Thapa attended Nepal Medical College, worked as a general physician in Nepal, then came to the United States where she worked as a volunteer at the Veterans Administration Medical Center in Washington, D.C., mostly with substance abuse patients. She applied for a U.S. psychiatry residency slot and was matched with Howard University’s psychiatry residency program.
“Howard University has provided me with a lot of opportunities to explore and grow apart from gaining excellent clinical training,” Thapa commented. “The continuous encouragement, motivation, and guidance I have received from two mentors—Drs. Lawson and Malik—have been priceless.” William Lawson, M.D., Ph.D., is chair of psychiatry at Howard University; Mansoor Malik, M.D., is the residency program director.
Among the professional challenges Thapa has faced since coming to the United States, she said, were “learning how to navigate a completely different medical system from that of Nepal” and “attempting to help treatment-resistant patients. It is a challenge throughout psychiatry, of course, since we still don’t have diagnostic markers to guide us in providing personalized treatment.”
One of the surprises she has experienced since coming to the United States, she noted, was “discovering how aware of, and open about, mental illness people are compared with people in Nepal. In Nepal, stigma is huge, although things are gradually improving, at least in the larger cities.”
All that Thapa has accomplished might come as a surprise when one considers her unassuming personality. “Despite all her achievements, she remains a very humble person,” Slootsky observed.
“Mona is quiet, peaceful, loyal, and trustworthy,” Concepcion added. “If I were to choose one word to describe her, it would be ‘equanimity.’ ”
“It is always a pleasure to observe a butterfly emerge from a cocoon,” Lawson stated. “In this case, it has been Mona Thapa who came to our program with a very quiet demeanor, soft voice, and shy smile. . . . I am looking forward to the impact that this butterfly will make on the field as she flies to the future.”
So is Thapa planning on returning to Nepal or remaining here in the United States? “Two years ago, I would have said that I would be returning to Nepal after my residency,” she said. “At this point, I would still like to contribute to mental health in Nepal. But I have not yet figured out how to do that the most effectively.” ■
A video interview with Mona Thapa, M.D., discussing why psychiatrists should be concerned about human trafficking can be accessed here.
