A few days ago, shock and grief engulfed a village within Rongai Sub County in Nakuru following the death of a member of a prominent political family after he reportedly took poison, citing ‘domestic problems’
And hours after this tragic death, A retired veterinary officer’s family was thrown into mourning after their 29 year old daughter, an accountant with a state corporation plunged to her death into a well at their home in Baruti Village.
What is even more baffling is that the account is the fifth person in the area reported to have committed suicide in the last one year.
Elsewhere in Njoro Sub County, Jerome Murage 33 is lucky to be alive. He has attempted suicide three times. The most recent was in November 2018. He is currently undergoing counseling for depression.
Suicides and other bizarre incidents of violence that have become commonplace across Kenya have been attributed to mental disorders.
According to the Kenya Mental Health Policy (2015-2030), about 40 per cent of in-patients in the country’s health facilities suffer from mental disorders. The World Health Organization estimates that globally 540 million people suffer from mental disorders, with three-quarters of them living in middle and low income countries.
Some of the more common mental disorders in the country listed by the Kenya Mental Health Policy (2015-2030) include bipolar disorder, dementia and schizophrenia, which globally affect about 60 million people.
The Nakuru County Governor, Lee Kinyanjui says that mental health in Kenya remains grossly underfunded, forcing most of those suffering from such disorders to seek private treatment which is very costly.
“I am however very impressed by the growing number of patients seeking mental health care services. The County is working with the National government to ensure patients who cannot afford to seek treatment from private facilities are assisted.
The governor stated that his administration will refurbish the Gilgil Mental Hospital at a cost of Sh. 40 million and that the devolved unit was in talks with the National government to secure grants that will finance operations of the mental health facility.
“For the next three years, we will be making budgetary allocations towards revamping the mental health facility. Due to high numbers of patients seeking services here, the facility needs an upgrade” said Kinyanjui.
Dr. Daniel Owino a Psychiatrist in private practice in Nakuru concurs, “Despite all the challenges, the good news is that many Kenyans affected by mental illnesses are slowly but steadily moving away from traditional and religious beliefs to seek normal treatment, a factor which is helping in managing the disease in the country.
“Research findings and common trends have pointed to the reality that most cases of mental related illnesses are more prevalent in urban areas compared to rural sides of the country. This is why you find higher concentration of psychiatrists in bigger cities,” stated Dr. Owino
When the Ministry of Health launched the Kenya Mental Health Policy 2015-2030, it stated that one in every four Kenyans will suffer from a mental disorder in their lifetime. Sadly as at 2016, there were only 88 psychiatrists – most of them located in Nairobi.
A research paper, “Providing Sustainable Mental Health Care in Kenya” by Prof. David Ndetei and Dr. Ana-Claire Meyer concurs that there is a dramatic shortage of human and other resources to effectively care for these disorders.
In the study, Prof. Ndetei and Dr. Meyer reveal that neurological disorders alone account for 11 percent of the burden of disease in Kenya. Among mental disorders, unipolar depression accounts for the highest burden of disease at 45 per cent.
And according to the Mental Health Atlas 2018 released by WHO, the ratio of mental health workers can be as low as 2 per 100,000 people in low income countries, compared to more than 70 per 100,000 in high income countries.
Thomas Ondimu, another Psychiatrist based in Nakuru estimates that it costs between Sh. 60,000 to Sh. 120,000 to treat mental illness minus the doctor’s consultation fee of between Sh. 10,000 to Sh 20,000.
Mathari, Kenya’s known public mental health facility requires a down payment of Sh. 10,000 before admission, but one can get express admission if he/she has the NHIF card.
“The cost of accessing treatment in private hospitals is inhibitive. Some patients part with between Sh.3, 000 to Sh.5, 000 per day every time a psychiatrist visits. And If a psychologist is roped into the treatment they will charge an additional Sh.4, 000 per visit. And some doctors recommend a patient to stay for between 2-3 months before recovery,” said Dr. Ondimu.
He states that there is need to build more specialized public hospitals for mental health to enable patients from low income areas also come out and seek services at affordable rates.
“Mathari National Teaching & Referral Hospital, which is the most commonly known public facility is not enough to take care of low income patients. There is a need for more public facilities to counter the private ones frequented by the middle income earners,” he notes.
He challenges the government through the ministry of health to allocate more funds to building public mental hospitals like Mathari National Teaching & Referral Hospital.
According to the World Health Organization (WHO), half of all mental illness begins by the age of 14, but most cases go undetected and untreated.
With about two million cases of depression annually, Kenya ranks second in East Africa after Tanzania (2.1 million cases), according to WHO data. There are concerns that the number could be higher since there are people who are depressed yet do not seek treatment.
Nigeria, the most populous country in the continent, leads with seven million cases, followed by Ethiopia (four million) and the Democratic Republic of Congo (three million). Seychelles recorded the lowest number of cases in the world at 3,722.
The Kenya Mental Health Policy 2015-2030 provides for a framework on interventions for securing mental health systems reforms in Kenya in line with the 2010 and Vision 2030. It further seeks to promote high standards of mental health in the country.
The policy seeks to address the systemic challenges, emerging trends and mitigate the burden of mental health problems and disorders.
By Jane Ngugi