The following story was published by The Star Newspaper on October 2018 following World Mental Health Day. View the publication HERE.
Contemplation over the power of a healthy mental state poured itself all over the globe in the wake of World Mental Health Day on October 10. Statistics ran through news channels, revealing how over 800,000 people die due to suicide every year globally, of which 75 per cent occur in low- and middle-income countries.
Moreover, Lady Gaga marked this year’s observation of the day with an opinion piece terming mental health an emergency. “By the time you finish reading this, at least six people will have killed themselves around the world,” read the article co-written with Tedros Adhanom, Director General of the World Health Organisation.
Conversation around mental health care is getting amplified as stakeholders hold forums to dissect and elaborate mental health. However, the need to walk the talk is beckoning, lest we lose more lives.
MEETING MENTAL ILLNESS
I first met mental illness in 2008. Munyao, a family friend, took his own life after strangling his wife, Kaluki. Munyao had been an alcoholic for as long as I could remember. Four years before his demise (2004), there was a call-out in our local church to contribute money for his admission at a rehabilitation centre.
In 2006, there was another call for more contribution to send him to a mental hospital, with the announcement citing that he had been diagnosed with clinical depression. After six months at the hospital, he returned home to rumours that Kaluki was having an affair with the very same pastor who raised funds for his recovery.
After a heated argument about the affair, Munyao tightened a kettle cord across Kaluki’s neck until she fell on the floor. When he returned home and found her on the floor ice-cold, he scribbled a note and consumed Rat Rat, the rodenticide.
“God forgot about me, so did my family. What am I living for? This earth is not a place to be. Goodbye World!” the note read.
Jane Mukami, a sought-after Kenyan fitness trainer, will tell you that she met mental illness when her brother, Stephen Githehu, was diagnosed with post-traumatic stress disorder. When he started to withdraw and send suicidal texts, the family reached out to various authorities in the United States, where he lived, and Kenya to help check him into a mental hospital. Police said that unless he does something that calls for his admission, they cannot involuntarily check him in. In February 2017, Stephen shot himself in his apartment.
Catherine Kariuki, the mind behind popular blog Fashionable Step Mum, met mental illness when her step-son, Josiah Kariuki shot himself in the shower with his father’s gun in May 2017. The Kariukis knew Josiah’s struggles with depression and had a counselor on retainer.
Globally, the film industry lost Robin Williams, who hanged himself in his California home in August 2014. His wife, Susan Williams, said in one of her first interviews since losing her husband that he had been diagnosed with Parkinson’s disease three months before he died. The disease affected his mental state, but it was Dementia with Lewy Bodies (DLB) that probably led him to suicide.
Frequently misdiagnosed, DLB is the second-most common neurodegenerative dementia after Alzheimer’s and causes fluctuations in mental status, hallucinations and impairment of motor function. Unfortunately, it was not until after his death that an autopsy confirmed he had the disease. Susan added that Robin had also struggled with addiction during his life but had been clean and sober since 2006.
The music industry was robbed of DJ Avicii in April 2018. In a statement released to the media by his family, they termed him an over-achieving perfectionist who traveled and worked hard at a pace that led to extreme stress. They further described his last days as a season of seeking happiness and balance.
Suicides around the world have been attributed to mental disorders and substance abuse. Evidently, mental disorders are highly prevalent and burdensome across the globe. This makes mental health a significant contributor to the overall public health burden, hence integration of mental health into primary care is a crucial task.
Early identification and effective management are also key to ensuring that people receive the care they need. Rajneesh Osho, an Indian religious leader, authored a book titled: The Mind: A beautiful servant, a dangerous master. Osho was right.
MENTAL HEALTH CARE IN KENYA
Statistics show that the prevalence rate of common mental disorders in Kenya is 10.8 per cent, with no gender difference. In addition to that, neuropsychiatric disorders in Kenya are estimated to contribute 5.7 per cent of the global burden of the disease. Yet, there is only one psychiatrist per 500,000 people. Higher rates of mental illness are registered in those who were of older age and those in poor physical health.
In May 2016, the Health ministry launched a mental health policy, whose objectives included reforming the system by addressing issues such as lack of leadership in the sector. The proposed reforms included appointing a board, increasing funding, training of service providers, and amplifying public awareness. This was a laudable commitment but remains unimplemented.
Today, mental health is barely incorporated into Kenya’s primary health care system. This could explain why the biggest mental health facility in the country, Mathari Teaching and Referral Hospital, remains understaffed, overcrowded, and underfunded.
The Health ministry permits primary health care doctors to prescribe psychotherapeutic medicines. Likewise, official policy enables primary health care nurses to independently diagnose and treat mental disorders within the primary care system.
HOPES FOR THE FUTURE
The sun is rising above mental health, as the world grows more aware of the need to address it. The United Kingdom government, for instance, appointed the world’s first Minister of Suicide Prevention.
The appointee, Jackie Doyle-Price, will lead in prioritising mental health in the UK. She is set to host the first Global Ministerial Mental Health Summit in London. African governments should borrow a leaf or two and invest in including mental health in Africa’s health care systems.
Association between common mental disorders, equity, poverty and socio-economic functioning are relatively well explored in high income countries. On the contrary, there have been fewer studies in low and middle-income countries, despite the considerable burden posed by mental disorders and their potential impact on development, especially in Africa. Consequently, the gap between what is urgently needed and what is available to reduce the burden remains very wide in Africa. With research and comprehensive analysis reports, statistics can be used to formulate evidence-based policies and expedite informed action.
However, before statistics and policies deliver the silver bullet, we all need to deliberately provide social support to the people around us. Dr. Joanne Cacciatore, an American advocate for mental health, said it best:
“There simply is no pill that can replace human connection. There is no pharmacy that can fill the need for compassionate interaction with others. There is no panacea. The answer to human suffering is both within us and between us.”
We need to look out for each other and introduce mental health into our everyday conversations.
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