Behind the smiles, laughter, and companionship that punctuates everyday conversations at social places, lies a dark cloud of stress, substance abuse, taxing cultural expectations and sundry burdens that men bear on their shoulders daily.
Statistics from medical records show that about four Kenyans die by suicide every day, and about 80 percent of these deaths involve men. This revelation highlights that men are among the most affected when it comes to mental health challenges.
A psychiatric nurse at Molo Sub-County Hospital, Ray Rono, says overbearing societal expectations placed on men have contributed to their silence when faced with emotional struggles.
This, he notes, has often bred cases of depression, substance abuse, and suicidal thoughts.
The Medic advises men to seek formal medical attention and urges both government agencies and non-governmental organizations to strengthen sensitization and awareness on men’s mental health.
Rono regrets that most men do not speak up because of masculinity, where society reinforces expectations of proving themselves tough, self-reliant, bottling up emotions and the ability to handle struggles on their own.
“This socialization by the society has greatly contributed to depression, substance abuse, and suicide among men,” adds the medic.
To address the scenario, Rono recommends formal medical checkups where they can get proper assessment and diagnosis.
He adds that mental health issues overlaps; for instance, depression could look like thyroid problems, stress, or substance use withdrawal, where only a psychiatric nurse or doctor can rule out medical causes and give the right diagnosis instead of resorting to guesswork.
Rono added that formal medical care creates a support system where clinics offer more than just medication to include services such as psycho-education and psychosocial support.
Ashton Ogutu, a businessman in Molo, says men are afraid to speak up due to the fear of being judged or being taken to rehabilitation facilities, which at times can be costly.
He advises men to seek out someone they trust when stressed, noting that many people are more comfortable opening up to peers who use substances than seeking help from responsible or prudish individuals.
“When it comes to dealing with stress, I usually talk to my friends because a problem shared is a problem half solved,” added the businessman.
Joseph Thiong’o, a youth, says men struggle to talk about mental health because of fear of judgment. He adds that when overwhelmed, he isolates himself or talks to friends.
“I deal with stress by isolating myself and sometimes listening to music. I think men should not keep quiet when they are going through challenges, and the government should increase awareness about mental health among men,” he advised.
Nakuru County has trained 3,689 health workers to provide specialized mental health support in a move aimed at strengthening community-level mental health services.
County Mental Health Coordinator, Lydia Nyaga said the trained health workers who comprise 3,459 Community Health Promoters (CHPs) and 230 nurses and clinicians, were expected to offer first-line support and initial psychosocial care for mental health disorder patients, raise awareness, and refer affected community members to specialized mental health services centres where necessary.
The coordinator said the health workers had undergone extensive training to help in detecting and addressing mental health challenges at community level, courtesy of an initiative supported by AMREF and Johnson & Johnson (J&J, adding that there was a notable increase in referrals by Community Health Promoters (CHPs) of mental health disorders to formal health facilities for further care and specialist support following the training program.
Nyaga stated that the CHPs were also enhancing continuity of care by following up on referrals, promoting adherence to treatment, and offering basic psychosocial support.
The economic burden of mental health issues is staggering; the African Mental Health Research and Training Foundation estimates Kenya loses nearly Sh50 billion ($340 million) annually due to productivity losses linked to mental health challenges.
The Foundation notes that access to mental health services is critically limited in Kenya, which has fewer than 100 practicing psychiatrists for a population of over 53 million.
Most mental health facilities are concentrated in urban centers. The cost of seeking mental health care, combined with cultural stigma, hinder many from accessing the help they need.
According to official statistics from the County Government, schizophrenia, bipolar disorder, major depression, substance use disorders, and neurodevelopmental conditions such as autism and ADHD are the most prevalent in Nakuru.
In Kenya, about 25 percent of outpatient visits and 40 percent of inpatient admissions to health facilities relate to mental health conditions, according to the Ministry of Health.
Conditions such as depression, stress, burnout, anxiety disorders, substance abuse, and post-traumatic stress disorder are prevalent, with one in four Kenyans likely to experience a mental health issue at some point in their lives according to statistics from the Ministry.
As mental health gains recognition as a public health crisis, international efforts are increasing to address the issue. The United Nations has included “mental health and well-being” in the Sustainable Development Goals (SDGs), particularly under SDG 3, which focuses on good health and well-being.
While this global spotlight is crucial, experts have indicated that more effort should be made in translating these aspirations into tangible improvements, especially in resource-limited settings like Kenya.
In Kenya, the Mental Health Amendment Bill 2022 was a step in the right direction, aiming to prioritize mental health and establish a mental health board to advise the government. However, mental health experts have indicated that legislation alone cannot solve the issue; they hold that increased funding, community engagement, and partnerships across public and private sectors are essential.
A recent study by the Ministry of Health revealed that many middle and top-level organizations in Kenya, including government departments and agencies, are populated by workers who are suffering unattended from a wide range of mental illnesses, including depression, stress, anxiety, suicidal thoughts and anger.
The research has also shown that these health problems cause more days of work loss and work impairment than many other chronic conditions, like diabetes, asthma and arthritis.
One of the most visible and devastating manifestations of the mental health challenge is suicide, estimated at about four cases per day by the World Health Organization.
by Wanjiru Esther and Wayne Angweye
