By J, KNA
2,250 Community Health Promoters (CHPs) in Nakuru will be positioned to provide first-line support, offer initial psychosocial care for mental health disorders, raise awareness, and refer affected community members to specialised mental health services where necessary.
Already, 1,000 CHPs have completed extensive training to detect and address mental health challenges at community level, while a further 1,250 are expected to graduate in the coming days from a training programme supported by AMREF and Johnson & Johnson (J&J) in a broader strategy to strengthen community-level mental health services.
AMREF’s Program Manager Dr Catherine Kanari said a notable increase in referrals by CHPs of mental health disorders to formal health facilities by CHPs for further care and specialist support had significantly increased since the training began in August.
Dr Kanari stated that training had been designed to equip the participants with skills to create awareness and provide accurate information towards reducing the stigma and discrimination associated with mental health ailments.
“Training CHPs aims to foster improved health outcomes by strengthening community-level mental health services. CHPs serve as a crucial link between their communities and the formal health system, making essential health services more accessible,” she indicated.
She said the initiative was aimed at creating a more supportive and responsive healthcare environment for both patients and healthcare providers.
Dr Kanari who was accompanied by Senior Manager – Programme Delivery and Impact, Africa and Middle East – Global Health Equity at Johnson and Johnson Dr Regeru Njoroge spoke during a meeting with the County Health Management Team (CHMT) to assess the progress of the training program.
The training program facilitated through the electronic Community Health Information System (e-CHIS) platform targets to reach all the CHPs in all the 11-Sub-Counties within the devolved unit.
“The program is part of our strategy focusing on providing support within communities and at workplaces, including training of supervisors to recognise signs of mental health issues and offer appropriate support,” noted Dr Kanari.
E-CHIS is a digital platform developed and implemented by the government to digitize community health services. It supports Community Health Promoters (CHPs) by replacing paper records with a mobile application for managing household data, tracking patient care, and enabling data-driven decision-making at national and county levels.
It is a key component of the national strategy to digitize community health services in Kenya, aiming to improve data accuracy, consistency, and timeliness. It facilitates better data collection, analysis, and reporting for community health workers, supervisors, and health system managers.
During the meeting, Johnson and Johnson disclosed plans to support capacity building in level 4 and 5 facilities health care facilities, targeting clinical officers, doctors, pharmacists and nurses.
Dr Njoroge indicated that the program that kicks off in October will also focus on providing psycho-educational support and training for health care professionals across all cadres towards promoting free discussion on mental health challenges and empowering members of the Kenyan society on how to identify, cope and respond to mental health concerns.
To create a mentally healthy community, he advised community leaders and superiors at workplaces to understand the unique needs of individuals and interventions needed to protect and promote mental health in homes and workplaces.
He said it was important to open up channels of communication in the community and workplaces as a way of detecting any form of stress and any trigger that may lead to depression, stress or mental illness and act immediately.
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 50 million.
Most mental health facilities are concentrated in urban centers. The costs of seeking mental health care, combined with cultural stigma, hinder many from accessing the help they need.
Dr Njoroge indicated that mental wellness is a vital component of societal health, economic productivity, and overall development.
He suggested that its costs, both financial and human, should be prioritized in policy planning and resource allocation due to its significant social and economic implications.
Consultant psychiatrist Dr Cleophas Wafula highlighted schizophrenia, bipolar disorder, major depression, substance use disorders, and neurodevelopmental conditions such as autism and ADHD as 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 1 in 4 Kenyans likely to experience a mental health issue at some point in their lives according to statistics from the Ministry.
Dr Wafula flagged the mental issues that also include attention deficit hyperactivity, schizophrenia and bipolar disorder as a silent pandemic afflicting Kenyan society in large proportions that no one wants to talk about.
He warned that putting mental health of the society on the back burner means an increase in reported violent crimes, homicides, suicides, gender-based and sexual violence.
Most of the disorders, he said, are triggered by both work related and social issues
Dr Wafula pointed out that as mental health gains recognition as a public health crisis, international efforts are increasing to address it. 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, he said efforts should be made in translating these aspirations into tangible improvements, especially in resource-limited settings like Kenya.
He maintained that addressing the true cost of mental wellness begins with breaking the silence surrounding mental health.
The Mental Health Amendment Bill 2022 was viewed as 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.
Counselling experts have highlighted the need to embrace open and honest conversations within the family unit explaining that seeking professional counselling would help in navigating complex emotions.
Studies by various stakeholders have 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 studies also show 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 Organisation.