Nakuru County Government has increased budgetary allocation and manpower towards prevention and clinical management of mental illnesses that have spiked amid Covid-19 and lifestyle changes.
Deputy Director in charge of Administration and Planning Dr. Joy Mugambi said that the devolved unit had formulated a policy and legislative framework to facilitate more investments in mental health care.
Dr. Mugambi indicated that other interventions that were being prioritised include grassroots advocacy to reduce stigma and discrimination associated with mental illness, adding that the County administration and other stakeholders have adopted a strategy to promote financing and investments required to scale up access to quality and affordable mental health care services in all the 11 Sub-Counties.
She made the remarks during a mental health stakeholders’ forum that was convened at the Nakuru Level 5 Teaching and Referral Hospital, which brought on board legal experts, employers from both public and private sector, borstal and educational institutions, substance abuse rehabilitation centres, psychiatrists and counsellors among others to deliberate on strategies to improve mental health wellness in the County.
“The County has established psychiatric units in all its14 level four and level five hospitals which has helped increase access to affordable mental health services. We have also employed more than 120 psychiatrists, mental health nurses, psychologists, social workers, occupational therapists and general staff who provide mental healthcare services at different levels,” she confirmed.
At the same time, Dr. Mugambi has expressed concern that most Kenyans were unaware that the Mental Health Act 2014 criminalises any insurance provider that discriminates against people with mental illness, while the National Health Insurance Fund (NHIF) fully covers mental illness treatment in any hospital that has a psychiatrist.
While noting that nearly four million Kenyans suffer from a mental disorder, the Deputy Director stated that 20 to 40 per cent of locals seeking out-patient services and about 40 per cent of in-patients in Nakuru’s health facilities have one or more mental disorders.
She added, “The increase in urbanisation is creating an individualistic society which is disconnected from its social support system. This greatly predisposes people to mental illness. The County has been running programmes that encourage individuals to be self-aware and to pay attention to sudden changes in thoughts and behaviours. We encourage people who suspect that they or someone they know have a mental illness to seek early treatment and to keep tabs on any changes in their general health to minimize any chances of relapse,” she said.
While urging employers to factor in the welfare of their employees’ mental treatment services, Dr Mugambi said various studies had shown that depressed workers lose five hours and 36 minutes of productive work every week compared with one and a half hours for the non-depressed.
“The County has also been actively running campaigns that promote mental health check-ups to assess the state of our minds the same way we do dental, optical or body check-ups especially if one works in a high-pressure or stressful environment. The same applies to young children. Early medical diagnosis is crucial in supporting the recovery process and in ensuring your quality of life is not negatively affected,” she noted.
The Deputy Director affirmed that the devolved unit was reviewing over-reliance on medical-led interventions and redirected its commitment to addressing the social determinants of mental ill-health and exploring possibilities of providing community-based mental health services.
“People have better health outcomes when they access comprehensive mental health services within their communities than in institutional settings. The former provides an opportunity for them to access other support services that enable them to be productive members of the society,” she pointed out.
She said that the county is committed to plugging the funding gap that has derailed access to quality treatment for citizens suffering from mental illnesses including, depression, anxiety disorders, substance abuse, attention deficit hyperactivity, schizophrenia and bipolar disorder.
Dr. Mugambi observed that stress linked to Covid-19 scourge, modern lifestyles, alcohol and drug abuse, domestic violence and abject poverty have worsened the burden of mental diseases in the country.
Depression is the most common mental illness, affecting more than 300 million people worldwide, according to the World Health Organisation (WHO). It is also the leading cause of disability. When not attended to, it can lead to suicidal thoughts.
WHO estimates that about 800,000 people commit suicide every year and it is the second leading cause of death among youth age 15 – 29 globally.
Though Kenya’s suicide rate is below Africa’s average of nine deaths per 100,000, figures from the World Health Organisation show that the suicide rate per 100,000 people in Kenya is seven, with the rate for men being 11 and women three.
“Depression and anxiety disorder can be easily ignored because they are not as dramatic as conditions like schizophrenia, which is a chronic and severe mental disorder. Some people do not see the diseases as treatable, as they can easily be confused for stress,” noted the Deputy Director.
Dr. Mugambi stated that the devolved unit’s administration was leveraging on data, research, telemedicine, robust financing and policy reforms to promote access to quality and affordable mental health care services.
She added, “We have revitalized efforts to scale up funding, public awareness and novel clinical interventions to reduce the burden of mental illnesses in Nakuru. The county has adopted international best practices to boost response to mental disorders linked to genetics, social and environmental factors.’’
Dr. Mugambi pointed out that with about two million cases of depression annually, Kenya ranks second in East Africa after Tanzania with 2.1 million cases.
She revealed that there were concerns that the number could be higher since there are people who are depressed yet do not seek treatment.
According to WHO data, Nigeria, the most populous country in the continent, leads with seven million cases of depression, 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.
There are more than 200 classified forms of mental illness and many people suffer from more than one mental disorder at a given time, states the American Psychological Association.
Besides depression, some of the more common disorders are bipolar disorder, dementia and schizophrenia, which globally affect about 60 million, 48 million and 21 million people respectively.