Taboos around suicide and mental health, as well as a shortage of mental health information, prevent Bhutanese from accessing care even when they are in distress. The media typically does not report on suicides and the official public discourse emphasizes the happiness of the Bhutanese people. This silence about mental health issues, coupled with the country's modernization and urbanization, may be exacerbating the stressors from rapid social and economic change. Migration to the capital for education and jobs results in many individuals living outside the traditional structure of an extended family, leaving a gap in social support that manifests in the widespread impression that divorce, domestic violence, drug and alcohol use, mental illness, and even suicide may be on the rise. As traditional sources of social support are less available, the country's mental health infrastructure is not robust enough to fill the void.

Bhutan currently has three psychiatrists for a population of about 800,000. For the majority of Bhutanese, mental health treatment would be most easily accessed through trained health workers who provide outreach in difficult to access, low-resource villages. Yet the nurses and physicians who specialize in mental health identified the need for additional training among this important cadre because most health workers have only minimal understanding of mental health diagnoses and no formal counseling skills. Systemic changes in mental health workforce development and stigma reduction are needed to increase Bhutanese people's access to and utilization of mental health care.