Investigator(s)
| Submitter |
Kezang Tshomo Gidakom Hospital, Thimphu Kezang Tshomo 
|
| Principal Investigator |
Kezang Tshomo Gidakom Hospital, Thimphu Kezang Tshomo
|
| Co-Investigator(s) |
Sonam Wangzin Rabjay Eastern Regional Referral Hospital, Mongar, Bhutan Sonam Wangzin Rabjay
|
| Co-Investigator(s) |
Jamyang Yeshi Dorji Faculty of Traditional Medicine, Khesar Gaylpo University of Medical Sciences of Bhutan, Thimphu, Bhutan Jamyang Yeshi Dorji
|
| Co-Investigator(s) |
Samten Wangchuk Department of Acute Medicine, Noble’s Hospital, Douglas, Isle of Man Samten Wangchuk
|
| Co-Investigator(s) |
Choten Gyaltshen Department of Psychiatry, Central Regional Referral Hospital, Gelephu, Bhutan Choten Gyaltshen
|
| Co-Investigator(s) |
Thinley Dorji Department of Internal Medicine, Central Regional Referral Hospital, Gelephu, Bhutan Faculty of Postgraduate Medicine, Khesar Gaylpo University of Medical Sciences of Bhutan, Thimphu, Bhutan Thinley Dorji
|
| Co-Investigator(s) |
Dechen Wangmo Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan Dechen Wangmo
|
Title(s) and abstract
| Scientific title | Proportion of Depression, Anxiety, and Stress among Buddhist monks and nuns in selected Monasteries in Thimphu, Mongar, and Bumthang, Bhutan: a cross-sectional study |
| Public title | Proportion of Depression, Anxiety, and Stress among Buddhist monks and nuns in selected Monasteries in Thimphu, Mongar, and Bumthang, Bhutan: a cross-sectional study |
| Background | Mental health disorders contribute significantly to the global disease burden, with rising incidences particularly in low and middle-income countries. Depression and anxiety are leading contributors to disability and suicide worldwide, with South-East Asia showing high and variable prevalence rates. Bhutan has also seen increasing mental health disorders, particularly among adults, with depression and anxiety rising steadily over recent years. Although Buddhist monks and nuns are often perceived as protected by spiritual practice, studies from Thailand, India, Nepal, and China show notable levels of depression, anxiety, and stress among monastics. At the same time, traditional practices such as meditation may enhance resilience. Despite Bhutan’s deep-rooted Vajrayana Buddhist tradition and large monastic population, little is known about their mental well-being. Understanding mental health status and coping strategies in this population is essential to guide culturally relevant interventions. |
| Objectives | Among Buddhist monks and nuns in selected monasteries in Thimphu, Mongar, and Bumthang from March to June 2026, to describe the: 1. Proportion and severity levels of depression, anxiety, and stress using validated screening tools. 2. Sociodemographic characteristics and environmental factors of the participants associated with depression, anxiety, and stress. 3. Common coping mechanisms against stress, including the practice of meditation. 4. Patterns of mental health service utilization. |
| Study Methods | This is a cross-sectional study that will be conducted among adult monastics (monks and nuns) residing in selected monasteries in Thimphu, Mongar, and Bumthang districts of Bhutan over a three-month period from March to June 2026, with possible extension depending on the timing of approval from the Research Ethics Board of Health (REBH). The final sample size will be 384 participants, including monks and nuns who are at least 18 years of age and have resided in the monastery for more than three months. Data will be collected using interviewer-administered questionnaires comprising socio-demographic information, the Depression, Anxiety, and Stress Scale–21 (DASS-21), and the Brief COPE questionnaire (standard study tools). All study tools will be translated into Dzongkha. A stratified random sampling will be used to select the study participants. At each study site, participants will be selected through a random sequence generator from a full list of monks or nuns. Data collection will be conducted using REDCap. Data collectors will receive standardized training to ensure consistent administration and interpretation of the tools. Before participation, the purpose of the study, potential risks and benefits, and the voluntary nature of participation will be explained, and written informed consent will be obtained. Data will be exported from REDCap and analyzed using STATA version 18.0. Results will be presented as proportions and severity levels of depression, anxiety and stress among monks and nuns, the associated socio demographic characteristics, the coping mechanisms and the utilization of mental health services. As the study will be limited to selected monasteries in three districts, generalizability to the wider monastic population of Bhutan may be limited. Ethics approval will be sought from the Research Ethics Board of Health, Bhutan; administrative approval from the Ministry of Health and the monastic administrations. |
| Expected outcomes and use of results | The study is expected to provide baseline evidence on mental health status and influencing factors among monastics in Bhutan. Findings will support the development of culturally appropriate interventions, strengthen monastic support systems, and inform national mental health programs. The results may also guide integration of mental health awareness within monastic education and contribute to broader policy discussions on wellbeing in religious communities. |
| Keywords | depression, anxiety, stress, monks, nuns, Bhutan, monasteries |
Research Details
| Student research | No |
| Start Date | 01-Mar-2026 |
| End Date | 31-Dec-2026 |
| Key Implementing Institution | KGUMSB |
| Multi-country research | No |
| Nationwide research | Yes, with randomly selected geographical areas |
| Bhutan, Bhutan, Bhutan | |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Other (Mental Heath) Health Care Seeking/Utilization |
| Involves human subjects | Yes |
| Population-Based Survey | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | Approved |