Depression is the most common illness worldwide. Kenya was ranked at position four in Africa with 1.9 million people who have the condition (WHO Report, 2014).According to the Kenya Mental Health Policy (2015-2030), mental disorder cases in Kenya continue to rise rapidly. Estimates point that 20-25 percent of outpatients seeking primary healthcare present symptoms of mental illness at any one time, while government statistics indicate that at least 1 in every 4 Kenyans suffer from a mental illness at one point in their lives.
In recent times, we are waking up to many shocking incidences ranging from people including school children committing suicide, others murdering their loved ones. Although not all these cases are attributed to depression and other mental related disorders, a good number have been confirmed to result from this. In almost equal stride, many people including prominent personalities have come out sharing their mental health challenges. Some have shared how despite having been top performers in their jobs, they abandoned their jobs or terminated due to non-performance arising from lost interest. Others turning to alcohol and substance abuse as others cut relationships with their close family members. Despite the doom and gloom associated with mental illness and those who have embraced it not only get well but set a precedent for others that the condition can be managed. .
Why Mental health Matters
The Kenya Mental Health Policy (2015-2030) states “Mental health is a key determinant of overall health and socio-economic development. It influences individual and community outcomes such as healthier lifestyles, better physical health, improved recovery from illness, fewer limitations in daily living, higher education attainment, greater productivity, employment and earnings, better relationships with adults and with children, more social cohesion and engagement and improved quality of life,”
Challenges facing Mental Health Management and Treatment in Kenya
Low Awareness: One of the biggest challenges is low awareness of mental disorders, particularly, the symptoms of this condition among the persons suffering from the condition and community at large. The fact that the symptoms affect emotions, thoughts and behaviors make it difficult to understand and accept. This has largely led to conformity of norms, where mental illness continue to be marred by myths and misconceptions including being a curse, witch craft, spiritual problem etc. instead of a disease that can be treated and managed if and when addressed appropriately. More often the affected person(s) resort to isolation and don’t seek medical help.
Cost and Management of treating mental illness in Kenya: In Kenya, mental health is underfunded and there is no separate budget for mental health. The country has approximately 100 psychiatrists for a population of 45 million (ratio 1:450,000). In addition, clinical psychologists and medical social workers who are central to the management and treatment of mental illness are very few. They are relatively inaccessible to the majority who need mental health services due to geographical distance as majority are based in the urban areas with high consultation fees. This forces most of those suffering to seek private treatment which is very costly and those who cannot afford are force to deal with their conditions themselves without professional assistance (WHO Mental Atlas, 2014). According to the Office of the Auditor-General (OAG), the referral system in place cannot work for provision on mental healthcare services since most of this staff are unavailable in almost all institutions in level 1 to 4 of the referral systems while others are thinly distributed between level 5 and 6 facilities. Mathari Hospital, is the only affordable public facility and the only public hospital in the country offering specialized psychiatric services and training.
Ongoing Mental Health Interventions in Kenya
The Kenya Mental Health Policy (2015-2030) provides a framework on interventions for securing mental health systems reforms in Kenya. This policy seeks to address the systemic challenges, emerging trends and mitigate the burden of mental health problems and disorders. It aims at ensuring people have access to comprehensive, integrated and high quality, promotive, preventive, curative and rehabilitative mental health care services at all levels of healthcare and strengthen mental health systems especially from the community level.
To realize the above and with the aim of bridging this human resource gap, Ministry of Health (MOH) – has been training community health volunteers (CHVs) on how to address common mental health problems so they can effectively offer assistance to people suffering from the same. The training focuses on a novel cost-effective method for treating common mental illnesses – such as depression, anxiety and chronic stress – known as Problem Management Plus (PM+) which has been approved by the World Health Organization (WHO). This is in the view that effective mental health interventions must be cognizant of the diversities in our environment. The WHO states ‘Presenting mental health care services in culturally-sensitive ways may be essential to increasing access to and usage of mental health care services, as local beliefs about mental health often differ from the Western biomedical perspective on mental illness. Before changing practices, evaluating the existing practices by mapping clinical outcomes is a helpful route. Governments should move away from large mental institutions and towards community health care, and integrate mental health care into primary health care and the general health care system.
In view of the above, it will be important for all health stakeholders to take up mental health as a serious health issue. They need to undertake intensive awareness campaigns on the condition, prevention, early symptoms and management and treatment services. The Government should also allocate more funding to mental health services and train health workers at all levels to manage and treat mental Health Challenges. At the community level, grassroots advocacy present both opportunity for empowerment towards demystifying stigma and influencing policy through ground up advocacy to effectively address the challenge.
- https://www.theelephant.info/reflections/2019/05/03/am-i-going-mad-a-reflection-on-mental-health-in-kenya/ -The Elephant – Speaking truth to power
- World Health Organization. WHO’s mental health Atlas. J Nutr Educ. 2014. http://www.who.int/mental_health/evidence/atlas/mental_health_atlas_2014/en/
- WHO Report. https://www.pressreader.com
- Office of the Auditor General (OAG). Performance Audit Report on Provision of mental health care services in Kenya. 2017