Psychiatric Disability Organization (PDO) is saddened by news reports emerging early Monday morning indicating that a number of psychiatric patients escaped from Mathari Mental Hospital after the doctors’ strike begun.
There were reports that police were sent to “arrest” and return the patients who escaped. This is an even more sickening scenario given the nature and presentation of psychiatric disorders, a challenge the police are not trained to handle.
Moreover, a video of citizens cheering on patients as they escaped from the hospital that is doing rounds on social media is even more worrying. Kenyans don’t seem to understand that the facility is also used for the treatment of convicted offenders who could be a danger to themselves or the society if their treatment is abruptly stopped.
However, as the police do ‘their work’ the big question is, after they are returned to the unmanned wards, what next? Will the police man the psychiatric wards? Who will administer drugs to make sure they are not a danger to self or others?
It is a fact that health workers including psychiatry staff are indisputably entitled to a voice in the terms of their employment, just as employees in any industry are. However, unlike other health departments, psychiatric wards, and psychiatric hospital serve a very special need in the society, one that is not equally served in private hospitals.
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There are dozens of patients who were admitted to these hospitals 40-50 years ago. They know no other home and family apart from the hospital wards and hospital staff.
On the other hand, many patients are on longer-term treatment for mood, anxiety and psychotic disorders. Abrupt discontinuation of such drugs can affect the course and prognosis of both mood and psychotic disorders, thereby having serious, long-term impacts on the patients’ health and well-being, including risks of suicide or homicide.
I understand the ethical dilemma presented by the decision of health workers to go on strike. The unjust treatment of any employee is intolerable.
Sadly, overworked, understaffed and underpaid employees man psychiatric hospitals and wards in Kenya. This is not only to their detriment but also to the detriment of psychiatric patients who depend on the attentive care of their medical providers.
I have interacted with these dedicated workers who clearly have a strong attachment to their work and have developed long-term relationship spanning decades with their patients. Leaving someone who you have cared for and seen improve must have left striking staff with psychological wounds.
Whereas it is within the rights of psychiatric staff to embark on a strike action, PDO holds that both the doctors and the Ministry of Health should have endeavored to provide a certain level of minimum service to psychiatric patients who stand to suffer severe consequences if their psychiatric care is withdrawn or temporarily halted.
Whereas it may be argued that such compelling moral duties or ethical obligations may conflict with the right to justice for the health workers, the question remains – what about patients’ human right to health?
There is a need for us as a country to rethink and reorganize our mental health sector. This is the most poorly funded, understaffed and poorly equipped health department in the country, which leaves me more convinced that the government has sadly institutionalized mental health stigma through systemic neglect.
As the strike enters its second day, the role of psychiatric staff during the strike requires further discussion, as the stalemate between the unions and the government continues. Missing a dose of psychiatry medication could mean that someone is a danger to self or others in the society and the consequences could be catastrophic.
May sobriety prevails.
The Author is mental health and child rights advocate and the Founder/CEO of Psychiatric Disability Organization. He can be reached on: [email protected] Website: http://www.pdokenya.org/ Facebook: https://www.facebook.com/Psychiatricdisability/