Four years after its establishment, The PEMA Secretariat has emerged as a central pillar of Bhutan’s mental health and protection response, expanding services from prevention and crisis intervention to specialised treatment, rehabilitation and reintegration.
Since 2022, The PEMA has managed 2,804 protection cases, received 2,065 calls through the PEMA Helpline (1098), provided residential rehabilitation services to 474 individuals, and extended mental health support across schools, communities, hospitals and correctional facilities. The Secretariat’s work is built around four key areas: prevention and engagement, response services, treatment and rehabilitation, and reintegration and aftercare.
Strengthening prevention and early intervention
A major transformation in Bhutan’s mental health approach has been the shift from responding only to crises towards prevention, early identification and timely intervention.
The PEMA has integrated maternal mental health screening into Mother and Child Health services across all 20 dzongkhags, recognising the importance of mental wellbeing during pregnancy and early childhood. In partnership with the Ministry of Education and Skills Development, more than 500 schools have developed wellbeing strategies to promote mental health awareness, identify concerns early and strengthen support systems for students.
Working with the Dratshang Lhentshog, The PEMA has expanded community-based mental health promotion programmes to 10 dzongkhags, with plans for wider coverage. To strengthen early detection among adolescents, The PEMA developed a web-based Health and Wellbeing Screening System for students in Classes X to XII. The platform helps identify concerns such as depression, anxiety, substance use, adverse childhood experiences and suicidal behaviours while enabling timely referrals and follow-up care.
Helpline becomes a lifeline
The PEMA Helpline (1098), launched in October 2022, has become an important access point for individuals seeking psychological and social support. The helpline has received 2,065 calls, with mental health concerns accounting for the largest share at 26.2 percent. Gender-based violence accounted for 11.6 percent, while marital issues represented 10 percent. Women comprised 67.5 percent of callers, while children accounted for 5.3 percent. Through the helpline, individuals are connected with counselling, protection services and other necessary support.
Expanding protection services nationwide
Between June 2023 and June 2026, The PEMA managed 2,804 protection cases across all 20 dzongkhags. Children in conflict with the law formed the largest category, accounting for 25.2 percent of cases, followed by violence against children at 20 percent and gender-based violence at 12.6 percent. The Secretariat reported that 99.2 percent of severe protection cases received a response within five hours, exceeding the required standard of providing support within 24 hours.
The PEMA Home, established as a safe shelter for children facing violence, neglect, abandonment and other vulnerabilities, has supported 40 residents, with 37 children successfully reintegrated.
Building specialised treatment capacity
The establishment of specialised facilities has strengthened Bhutan’s ability to provide mental health and substance use disorder services. The 60-bedded PEMA Centre in Thimphu, constructed at a cost of Nu 327 million, serves as the national referral facility for specialised mental health and substance use disorder care, offering child and adolescent mental health services, addiction management, counselling and treatment for acute and chronic conditions.
For substance use disorder recovery, PEMA Rehab (Mitshey Yarab Lamzang) has provided residential rehabilitation services to 474 individuals, with 386 completing treatment programmes. The Secretariat has also expanded substance use disorder services within correctional facilities. More than 707 inmates have received support through prison-based treatment programmes at Chamgang Central Prison and Lungzor District Prison.
Supporting recovery and reintegration
Beyond treatment, The PEMA has focused on helping individuals rebuild their lives through rehabilitation and reintegration initiatives. The BRAVE (Bhutan Reintegration and Value Enhancement) Programme supports vulnerable groups, including individuals recovering from substance use disorders, former prisoners, women and youth, through care, skills development, entrepreneurship and livelihood opportunities. Through the FEB Forward initiative, PEMA Rehab has provided skills training to 152 clients in traditional arts, music, digital literacy and vocational skills. The Secretariat has also supported reintegration through De-Suung programmes, providing former rehabilitation clients with further training opportunities.
Strengthening national capacity
Alongside direct services, The PEMA has invested in building long-term capacity to address mental health challenges. More than 1,500 education professionals, including principals, school counsellors, education officers and wellbeing focal teachers, have received training on basic mental health care, child protection and substance use prevention.
The Secretariat has also provided postvention support to more than 200 families affected by suicide over the past two and a half years. Between 2023 and 2025, Bhutan recorded 303 suicide deaths. Mental health challenges, alcohol use and family difficulties were identified among factors associated with suicide cases. The national suicide rate declined from 14.6 per 100,000 population in 2022 to 12.4 per 100,000 population in 2026, although Bhutan remains above the Sustainable Development Goal target of reducing the rate below 9.8 by 2030.
Nidup Lhamo, Thimphu
