Let's build on success of Uhuru administration on mental health

Mathari Hospital signage. [File, Standard]

Kenyans went to the polls on 9 August 2022 after a five-year cycle and the third General Election since the promulgation of a new constitution in 2010.

This marks the end of the second and final term of the Jubilee government under President Uhuru Kenyatta and his deputy William Ruto, the latter being the current President-elect.

The elections meant a large number of positions were up for grabs including president and deputy president; 47 governors and their deputies; 47 members of the senate; 47 women representatives; 290 Members of Parliament; and 1,450 members of the County Assembly.

For the entire country, this meant a back-to-back electioneering period, social economic realignment, political parties' manifesto launches and inevitably mental health stressors.

The outgoing regime took bold steps toward addressing issues of mental health. Starting with an announcement by President Uhuru Kenyatta during Madaraka Day of June 2019. President Kenyatta spoke profound words depicting a husband, father and grandfather.

He said: “Depression has today become a common phenomenon and it affects persons from all walks of life and ages.”

Thereafter a task force was formed in the Ministry of Health to give a report on the state of Mental Health in Kenya. The highlight of the report was to increase the mental health budget from 0.01 per cent to the global recommended 2 per cent of the health budget allocation.

Simultaneously a Bill was sponsored in the Senate by Nominated Senator Sylvia Kasanga and after successfully going through the parliamentary process for more than four years it become the Mental Health Amendment Bill 2020 through a presidential accent.

For the first time, an office of the Presidential Advisor on Mental Health was created and our very renowned Psychiatrist Frank Njenga become the inaugural office bearer. 

Other notable and positive developments during this government tenure at the National level include the launch of a mental health investment case which highlighted the huge return on investments in productivity gains and social value of health upon a 10-year investment.

Worthy of mention was the conversion of Mathari Mental Health Hospital into a semi-autonomous facility meaning it is entitled to receive directing funding from the exchequer unlike previously through the ministry of health.

Last but not least the Ministry of Health last month launched a suicide prevention strategy which comes on the heels of calls for decriminalisation of suicide which Coalition Action for Preventive Mental Health Kenya (CAPMHK) is an amicus curie in the litigation currently at the High Court.

At the bedrock of all these great achievements within a short time and especially at the pinnacle of Covid-19, other glaring shortcomings have not gone unnoticed that shall be areas of advocacy and policy alignment or formulation.

Firstly, the budgetary allocation at National and County levels towards mental health still remained very insignificant and skewed towards medicine and salaries as reported by the task force, the Government is yet to decentralise services from hospitalisation to community-based approaches as recommended by the Mental Health investment case.

Suffice to say it was baffling to see the President launching the construction of a Mental health facility in Kajiado County at the height of UNOHCR call for deinstitutionalization knowing very well that Kenya is a state party to the CRPD. Article 14 of the Convention - whether under mental health acts or otherwise, prohibits involuntary detention based on disability. States parties should immediately stop new placements in institutions, by adopting a moratorium on new admissions and on the building of new institutions, wards, and refrain from repair or maintenance.”  

The enactment of the Narcotics, Drugs and Psychotropic Substances (Control) Act 2020 has been a retrogressive achievement towards rehabilitation and reintegration of persons who use drugs. It is noteworthy that the president had initially rejected it.

The proposed punishments for possession have become more punitive and ambiguous for law enforcers. This is bound to create more strive and friction in the general public. The incoming crop of MPs will be tasked to amend this law and focus on harm reduction- treatment not punishment and alternative ways to curb the supply and demand of illegal drugs which have a mental health underlying theme.    

CAPMHK vision and existence is premised on advocating for more investments toward preventive and promotive aspects of mental health. We are privy to the fact that the incoming government made no specific pledges toward mental health investments during their campaigns and manifesto launches.

CAPMHK, however, runs an online initiative urging its members and the public to engage politicians and make them commit to Youth mental health.

Upon establishment in 2020 CAPMHK first task was to petition the National Treasury for increased budget allocation and we shall take to task the new government on this.