THE KENYAN PROBLEM: AN ANALYSIS OF MENTAL HEALTH CARE IN KENYA

In news making headlines in the recent past, a doctor in Nairobi committed suicide. This caught the eye of many, seeing that she was considered successful in many respects, and would thus not be expected to take such drastic measures. This brings to light the conversation on mental health and its place in the healthcare system in Kenya. The World Health Organization defines health as the state of complete physical, mental and social well-being and not just the absence of a disease.[i]

We would therefore rightly state that mental health entails more than just the absence of mental disorders or disabilities, and forms an essential part of health. It entails successful mental performance which would result in productivity, fulfilled relationships with other people, improved physical health and the ability to cope with the normal stresses of life. All these result in an improved quality of life with good social relations.[ii]

In Africa, majority of people with serious mental health disorders do not have access to treatment that they need.[iii]  There is a heavy burden of mental illness as a result of ill health, psychological disability and premature mortality, with huge gaps in accessing healthcare. Covid-19 has also not helped the situation, having caused a rise in the number of mental health related issues.[iv]

A World Health Organization report ranked Kenya the fifth among African countries with the highest number of depression cases.[v] Mental health experts have made an estimation that 1 in every 4 Kenyans may be suffering from a mental health related issue, ranging from mild to severe disorders.[vi] With all these damning statistics, the country is still struggling with providing affordable mental health care and treatment.

A key challenge we face is the low level of awareness of mental health disorders, and in particular the symptoms associated with each.[vii]

The WHO report further shows that Kenya was among the few states that did not allocate a separate budget for mental health, with a government expenditure that accounted to only 0.01% of the total budget.[viii] This translates to lack of adequate facilities, as witnessed by the audit on mental health by the Auditor General in 2017. This audit showed that a whooping 22 out of 47 counties in Kenya do not have psychiatric units.

This means that all the patients in need of mental health care have to be referred to Mathari National Hospital, the only national hospital specializing in mental health.

The culture of denial and silence that surrounds mental health issues only serves to make things worse. Associating mental illness with supernatural causes that has led many to seek help from traditional healers, if any.[ix] In Africa generally, the mentally ill are portrayed as being ‘mad’ and when such beliefs are compounded with common stereotypes, ignorance is perpetrated even further.

Depression, which is defined as persistent sadness and lack of interest or pleasure in previously rewarding activities, is one of the leading mental health issues diagnosed in Kenya.[x] Anxiety and substance use also form part of the highly diagnosed disorders in Kenya. The health care sector is, however, still quite rigid in realizing the importance of mental health in society’s realization of its goals. [xi]

As stated earlier, the pandemic has had a substantial negative impact on mental health. However, there is still no formal mental health response plan, with the state only declaring its commitment to mental health.[xii] The lack of a formal mental health response plan is largely influenced by the assumption that other diseases make up the biggest threats in the country[xiii], which is increasingly becoming a fallacy, if the statistics on the causes of death in the nation are anything to go by.

The stigmatization around mental health denies patients the empathy and understanding that has, over time, been given to the sick in the African society. This series thus seeks to raise awareness on mental health and push for policy changes.  From the background, it is clear that mental health should be given priority in public health to bridge the gap, even in a low resource economy.

Article by: Wendy Kuyoh

Wkuyoh@mmsadvocates.co.ke             

MMS Advocates


[i] Preamble, Constitution of the World Health Organization (2006).

[ii] Ministry of Health, Kenya Mental Health Policy, 2015-2030, 1.

[iii] Weston M and Sevaile S, ‘Mental health in Africa’ The Lancet Global Health, 2018, 1-< https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30303-6/fulltext> on 11 May 2021.

[iv] Ministry of Health, Mental Health Taskforce urges government to declare mental health a National Emergency Nairobi, 7 July 2020, 1.

[v] Murunga F, ‘World Mental Health Day: Suicide in Kenya’ African Population and Health Research Centre, 10 October 2019-< https://aphrc.org/blogarticle/world-mental-health-day-suicide-in-kenya/> on 7 June 2021.

[vi] Ministry of Health, Mental Health Taskforce urges government to declare mental health a National Emergency Nairobi, 7 July 2020, 1.

[vii] Ooko S, ‘Low cost approach to tackle mental illness in Kenya’ World Vision Kenya, 19 October 2018-< https://www.wvi.org/kenya/article/low-cost-approach-tackle-mental-illness-kenya> on 7 June 2021.

[viii] World Health Organization, Depression and Other Common Mental Disorders, 2017, 17.

[ix] Musyimi C and Ndetei D, ‘Exploring mental health practice among traditional health practitioners: a qualitative study in rural Kenya’ 2018 <https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-018-2393-4> on 7 June 2021.

[x] Goldman L, ‘What is depression and what can I do about it?’ Medical News Today, 22 November 2019-https://www.medicalnewstoday.com/articles/8933 on 11 May 2021.

[xi] Musyimi C and Mutiso V, ‘Mental health treatment in Kenya: task sharing challenges and opportunities among informal health providers’ International Journal of Mental Health, 2017-< https://ijmhs.biomedcentral.com/articles/10.1186/s13033-017-0152-4> on 7 June 2021.

[xii] Ndetei D and Meyer C, ‘Mental and Neurological Health Care in Kenya’ Providing Sustainable Mental and Neurological Health Care in Ghana and Kenya, The National Academic Press, 2016, 12.

[xiii] Ndetei D and Meyer C, ‘Mental and Neurological Healthcare in Kenya’ 12.

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