Over four months, a BHRF reporting team visited 14 district hospitals across six divisions, interviewed 62 patients, 18 family members, and 24 clinicians, and reviewed admission records where they were made available. The picture that emerges is uncomfortable: even in 2026, mental-health care at the district level is being delivered, when it is delivered at all, in conditions that almost no other clinical service would accept.
In one northern district hospital, the room marked "Psychiatric OPD" had been repurposed as a storeroom for vaccine cold-chain equipment. The visiting psychiatrist, who travels from a divisional centre once every two weeks, sees patients in a corridor. In another, a 19-year-old being treated for first-episode psychosis was discharged after three days because, according to the file note, "the family insisted and beds were needed."
"The pattern we kept seeing was that mental-health services existed on paper, were budgeted on paper, and then quietly absorbed into other services on the ground," said Sabrina Chowdhury, the BHRF reporter who led the project. "Stigma starts at the institutional level. It is the building telling you this is not real medicine."
The report contains documented exceptions. The Khulna Divisional Hospital and the upazila health complex at Lohagara were both running psychiatric outpatient services in line with the national mental-health policy and even maintaining patient registers. What separates them from the rest, several clinicians told us, is the personal commitment of a single senior administrator.
BHRF's full multimedia report, including video testimonies and a district-by-district scorecard, will be published next Tuesday.
