When mental illness knocks on your door

Symptoms of depression are harder to diagnose than those of physical illness. [iStockphoto] For the last 25 years, Rose Njogu*, a mother of three, has been the sole caregiver to her son who has a mental and developmental disorder. Her firstborn son, 25-year-old Maina* (not his real name), leaves their home in Nyeri County's Gititu area in Tetu, and walks to Nyeri town where he spends the day roaming the streets. In the evenings, he goes back home where his mother feeds him and gives him his medication. Mrs Njogu says that although her son takes his medicine and attends clinics weekly or after two weeks, containing him at home is a challenge. "When my son was born, the doctors noticed he did not cry like other children. I was informed by the doctors that he needed special care as his brain would not develop fully. Throughout his life he has been a very hyper child with aggressive anger," Mrs Njogu says. She explains that, as his primary caregiver, it has not been easy to bring up a child with mental health challenges since the community does not embrace them. She lives in fear that her son's daily trips to town could end in tragedy as people with mental challenges are sometimes beaten up by members of the public when they make a mistake. "I took him to Wandumbi Special School for his education but, unfortunately, after his rite of passage (circumcision), he refused to go back to school and goes to Nyeri town daily where he spends his time," the mother says. David Munene, a Community Health Promoter (CHP) in Nyeri's Majengo area says that the volunteers have noted that people with mental health challenges are often ostracised and considered a bad omen. "Mental illness can be made worse by drug abuse, poverty, and mistreatment by family," he says. He notes that, in his unit Majengo area, he refers people displaying symptoms of mental illness to the Nyeri County referral hospital where they are treated. Those with serious symptoms are admitted to a ward for further treatment. Munene, however, admits there is a shortage of psychiatrists, leading to a gap in accessibility to mental health services. The CHP observes that the most vulnerable people are those from poor families since the cost of mental healthcare is too high and mostly misunderstood. Munene explains that, in most cases, patients with mental illness are rejected and left in the towns where they live. Some relatives are never bothered, something that worsens their condition. "What I do is a passion for health volunteering as a way of giving back to the community. I try to restore the dignity that a person lost when they were mentally ill," he says. Munene acknowledges the challenges faced by the caregivers of people with mental illness since the patient is not able to follow instructions. Being a front liner on mental health Munene explains he must get consent from the family and seek permission from the authorities including the chief so as to take the patient to the hospital. "After taking the patient to the hospital the treatment starts by making the patient calm, while others are admitted for routine checking up," he says. Munene complains that some of the families living with mentally challenged people fail to embrace them back to their families after going through the treatment for unknown reasons. Stephen Kimotho, a psychiatric nurse, says that people with mental illness should be treated and taken care of and not abandoned. "This is a disease like any other. The patient should be taken to the hospital and treated. He or she should have routine check-ups and attend clinics," Kimotho says. Dr Julius Muiruri, the Nyeri County Referral Hospital resident psychiatrist reveals that the number of cases of depression has doubled in the past year. "At least one person out of the patients we are treating per day is suffering from depression," Dr Muiruri states. He explained that the symptoms of depression are harder to diagnose than those of physical illness but the impact can be overwhelming to the patient. "Mental illness is a disease like any other and the patients need to be treated with care and dignity. It can be healed if treated," he says. He warns the public not to abandon people with mental illness or refer to them as bad omens or bewitched. He says members of society should instead understand them and help them recover by reminding them to take medication and attend regular clinics. observed. However, the doctor noted that mental health is poorly funded and lacks support compared to other diseases hence the higher cost of treatment. "Mental illness is categorised under non-communicable diseases and is often forgotten and lacks funding compared to diseases such as diabetes and cancer," he says. He says that people with mental illness are not only those who walk on the streets and wear dirty clothes but even those who are well dressed and attend to their normal duties. Dr Teresa Wanjiru, a psychiatrist in the same hospital says depression is one of the leading diseases currently being treated at the facility. "I can attribute depression to harsh economic times as many people are unable to cope with the high cost of living," she says adding that drug abuse is also on the rise leading to addiction and worsening mental health. The psychiatrist noted other mental illnesses they are treating include anxiety disorders, bipolar disorder, post-traumatic stress disorder (PTSD) and schizophrenia. Dr Wanjiru says that mental illness is curable and the public should understand the patient. "Mental treatment is not one day but a process where the patient needs a follow up from weeks, months and sometimes even years," Dr Wanjiru said. She notes that some of the signs of mental illness include social withdrawal, change of behaviour, a sudden change of normal routine including eating too much or refusing to eat, lack of sleep or sleeping too much. Nyeri Health Services CEC Dr Joseph Maina Kiragu says that there is an increase in cases of mental illness within the county. "Even in the absence of actual figures, there is a noticeable increase of patients with mental illness and those seeking psychiatric services," the CEC said. He added that the Nyeri County government has a Health Action Plan 2023-2027 which will address mental illness challenges. Dr Maina noted the county government has started a programme where medics will be trained on Mental illness challenges at the Kenya Medical Training Center Nyeri branch to help in giving services to mental patients. At the same time, he said that Community Health Promoters (volunteers) are currently trained in a module to identify the early signs of mental illness and advise the family of the patient to seek help. "The community health volunteers are the first contact with the public through household visits and can help reach out to people with mental illness," Dr Maina said. He acknowledged that the treatment of mental illness is costly as compared to other diseases since it's not a one-time disease but a process of not less than three months. "Some people with symptoms of mental illness need to be admitted and treated so as to stabilise them," Dr Maina said. He also noted that the cost of rehabilitation services for those affected by drugs and alcoholism is too high which can amount to Sh60,000 for three months. The CEC explained that the county has set up a rehabilitation centre at Ihururu area, with a capacity of 90 patients, where people affected by drugs can benefit freely without charge. He noted that, currently in Nyeri County Referral Hospital, there is a specific ward for mental illness with a capacity of 30 patients.

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