Patients at the Mathari Hospital. Lack of funds hinders war on mental illness. PHOTO | FILE | NATION MEDIA GROUP
When the body of a 23-year-old man was found dangling from the
window of the mental patients' ward at the Nyeri county referral
hospital, residents reeled with shock at the height of negligence
existent at the facility.
The family blamed the facility for failing to protect their son, who had already tried to commit suicide at home.
The patient is said to have hanged himself using a pair of trousers inside the strong room in the mental ward.
This
needless death of a mental patient who was supposed to be under suicide
watch exposes the rot that has eaten into the country's public health
infrastructure particularly in relation to mental health services.
In many parts of the country, grim statistics paint the picture of a mental health capacity that is virtually non-existent in public health programmes across the counties.
SUICIDE
The World Health Organisation estimates that about 800,000 people die by suicide each year.
According
to a research paper, "Providing Sustainable Mental Health Care in
Kenya" by Professor David Ndetei of the University of Nairobi and Dr
Ana-Claire Meyer, there is a dramatic shortage of human and other
resources to effectively care for these disorders.
In
Nyeri, Meru and Murang’a counties, health department officials were
unable to reveal how much money is spent on drugs to treat mental illness.
The counties also face a shortage of psychiatrists, nurses and other
staff to take care of the patients who require close monitoring.
A
report adopted by the Nyeri county assembly described the psychiatric
section as the most neglected. The discrepancies in the wards range from
poor infrastructure and lack of drugs to dilapidated buildings.
MEDICAL SERVICES
At
the Murang’a level five hospital, the psychiatric ward accommodates
10-15 inpatients, but there is an addition 10 beds reserved for other
patients.
According to the hospital’s superintendent
Doctor Leonard Gikera, there are two nurses per shift (for eight hours),
who are running the ward.
When the Nation visited
the hospital on Thursday, family members of the patients told the
Nation that they were satisfied with the medical services offered at the
facility.
“I have a patient here and he has been well
attended to and in fact he is doing well. I’m very grateful to the
hospital management for catering to the patients’ wellbeing,” James
Mwangi, a father of one of the patients said. However, hospital staff
who talked to Nation on condition of anonymity said the ward lacked personnel as only three nurses were equipped with psychiatric knowledge.
The
Wajir county psychiatric unit is yet to be fully operational two years
after it was commissioned. The unit was commissioned in 2016 before
starting operations later on in that year, but it is yet to meet the
standards of a fully functional mental clinic.
20 PATIENTS
The
unit has a capacity of 20 patients comprising of 12 male patients and
eight female patients. In an interview with the Nation, the hospital
clinical officer in charge Robert Ogalo said that the clinic is only
offering outpatient services. He added that they were yet to begin the
in-patient services due to lack of personnel adding that the rooms are
not yet conducive to allow for admission.
In
Meru, the only in-patient psychiatric unit in the upper eastern region
is overstretched with the 16 bed facility sometimes having more than 40
patients. An official who spoke to the Nation said it is difficult to
turn away or refer patients with mental conditions leading to
congestion. The facility is also manned by seven nurses against a need
of 13.
“Out of the seven nurses, only
two have specialized training in handling psychiatric conditions. The
shortage of nurses in the unit has been blamed on a countrywide
challenge,” the official said. The unit often runs out of drugs, forcing
medics to send patients to chemists.
“Some
patients are brought by police and have no relatives to buy drugs. In
this case we have to source drugs from other centres or contribute from
our pockets to buy the drugs. At times, we have had to pay fare for
recovered patients when they are discharged,” he said.
MORE RESOURCES
The official said there was need for allocation of more resources to expand the bed capacity and hire more specialised nurses.
According
to the Mental Health Atlas 2017 released by WHO, the ratio of mental
health workers can be as low as 2 per 100,000 people in low income
countries, compared to more than 70 in high income countries. It is also
estimated that 540 million people suffer from mental disorders, with
almost three-quarters of them living in middle and low income countries.
Mental
disorders include those affecting mood, thinking and behaviour. It
accounts for 13 per cent of the global disease burden and WHO project
this will rise to 15 per cent by 2030.
Reporting by Irene Mugo, Bruhan Makong, Manase Otsialo, David Muchui, Grace Gitau, Ndung’u Gachane and Vivian Jebet
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