Why we are not getting our mental healthcare system right

Despite the gazettement of Mathari Referral and Teaching Hospital, which turned the facility into a state corporation, Kenya is still far away in addressing mental health issues wholesomely.

This, according to Dr Mercy Karanja, the acting head of Mental Health Department at the Ministry of Health, is due to myriad challenges.

Speaking to Healthy Nation in an exclusive interview, Dr Karanja noted that Kenya’s mental health taskforce put together by former President Uhuru Kenyatta gave 15 recommendations before ceasing to function in October 2020.

The taskforce recommended that the government ensures integration of the mental health information sub-system within the general health information system; and the establishment of a National Mental Health and Wellness Commission to advise the national and county governments on the state of mental health and happiness in the country.

It further advised the government to adopt a community-based mental health services approach.

“The services should be people-centred; recovery-oriented and with a human rights approach delivered through community mental health teams,” it said. However,  most of the 15 recommendations are yet to be implemented four years later.

But why?

“Some of them have been implemented but one of the biggest challenges we still have is financing for mental health, which cuts across from counties to the national level. This means that despite the recommendations to improve access to mental healthcare, minus financing, we are not achieving much,” Dr Karanja said.

Read: Are your mood swings just that, or a sign of something else?

“Secondly, there was a mental health investment study done in 2020, which shows that the government really needs to prioritise and invest in mental health,” the head of department said.

“This is why we are trying to push for more budgetary allocation by national and county governments. We wish to also request partners to help us bridge that financing gap.” 

Dr Karanja also pointed out that Kenyans are finding it impossible to use their health insurance cover when they go to health facilities offering mental health services.

“In terms of mental health treatment, the transition to Social Health Insurance Fund (SHIF)still means that only Sh60,000 is allocated to cover mental health issues, which is not enough, thus making treatment out of reach for many Kenyans,” she said, urging the government to increase that allocation. 

Mercy Musisi, a psychologist and manager at The Retreat Rehabilitation Centre that caters for individuals and families with substance abuse disorders as well as co-occurring mental disorders with branches in Limuru and Ngong, agreed with Dr Karanja.

“SHIF has a package for mental health but it’s not sufficient for private practice yet public hospitals are not enough to cover the population especially for inpatient services.”

Ms Musisi told Healthy Nation that insurances still look at substance use disorder as ‘self-inflicted’  and thus don’t cover it,  which only complicates a condition and risks it metamorphosing or triggering other conditions like mood disorders. 

Read: How workplace burnout hurts your health — and what to do about it

Both Dr Karanja and Ms Musisi agreed that there are several reasons why mentally ill people in the country may have difficulty accessing care.

They explained that some individuals may not be aware of the symptoms of a mental illness or the resources available for treatment.

They also cited a shortage of mental health professionals and treatment facilities, making it difficult for individuals to access care.

There are also systemic barriers such as  complex referral processes and a long waiting period to access certain services.  

Ms Musisi added that some Kenyans face stigma that arises from cultural myths and misconceptions.

“Some communities associate mental illness with witchcraft and curses. This makes some patients seek religious intervention even as symptoms  progress.

“The solution is simple: Let’s prioritise, invest in and finance mental health,” Dr Karanja urged government, donors, partners and stakeholders.

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