At 14, Charity Muturi was having suicidal thoughts but did not share them with her family.
She had alternating bouts of excess energy, fights of ideas, questionable generosity with irrational decisions followed by lows of self-isolation, hopelessness and neglecting personal hygiene.
Close family and friends assumed she had personality flaws. But the symptoms persisted and 27 years later, a psychologist diagnosed her with bipolar disorder in 2015.
Muturi was put on the first generic medicine that affected her kidneys three months later.
“I was forced to take low-quality medication, because I did not have a private insurance cover, yet the public cover did not cover for outpatient,” recalls Muturi, also a mental health advocate, adding that majority of patients default on treatment due to side effects.
Second-generation drugs, preferable in managing mental health illnesses, are only administered to inpatients.
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“It is worrying that in the last 100 years, we have neglected mental health as a country and as a result some people have been visiting traditional healers and spiritual leaders worsening their conditions,” said Muturi.
Her encounter mirrors Kenyans suffering mental health conditions which are diagnosed at advanced stages.
The common mental illnesses in Kenya according to the Mental Health Taskforce established by President Uhuru Kenyatta in 2019 include; depression and suicide, substance use disorder, bipolar disorder and schizophrenia.
The World Health Organisation (WHO) also estimated that at least one in every four Kenyans suffers mental health illnesses.
But Uhuru signed the Mental Health Bill, 2020 into law and which might change many things as the law mandates the provision of quality healthcare for all forms of mental illness.
Nominated Senator Sylvia Kasanga who proposed the Bill said Covid-19 altered statistics as today, probably one in three Kenyans, suffers mental health issues due to the adverse effects of socio-economic factors pegged to the pandemic.
“Mental health illnesses start from everyday life challenges like anxiety, stress, depression, and advanced mental illnesses like schizophrenia, psychosis, and extreme bipolar. Many Kenyans suffer without knowing they are suffering,” Kasanga added.
Under the law, the national government will allocate at least four to six percent of the health budget to mental health while the county governments will allocate four to six percent of their health budgets besides implementing mental health policies from level two to level five hospitals.
A section of the Act also notes the counties will be expected to have “dedicated clinics to offer outpatient services and community-based care and treatment for persons with mental illness” besides integrating mental health into the healthcare system
Kenya allocates only 0.01 percent of the budget for mental health. Annually, the country requires Sh12 billion for mental healthcare, which translates to Sh250 per person, but the State is spending Sh25 per person.
The law also mandates insurance companies to offset medical bills of patients with mental illnesses. Currently, health covers do not offset mental health bills.
In addition, the law promotes recovery, enhances rehabilitation, safeguards rights, and ensures integration of persons with mental illness into the community, besides reducing the impact of mental illness, including the effects of stigma.
“We are not saying that county hospitals should build mental health hospitals, because that increases stigma,” said Kasanga, “but rather have services integrated into the health system.”
Kasanga said she was extremely happy as “it has been a long journey of pushing to have an Act of parliament. This is a day of celebration for Kenyans who are living with mental illnesses, including police and armed force.”
Kasanga said she drafted the Bill due to neglect of mental health yet every citizen is entitled to dignified treatment in the Constitution.
Dr Neema Araka, a psychiatrist and senior registrar at Mathari National Teaching and Referral Hospital in Nairobi argues that “integrating mental health addressed in the law means more people can get access to mental healthcare, which will reduce the wide treatment gap.”
Currently, Dr Araka reckons “the country is making strides when it comes to de-stigmatization of mental health issues, but there is still more to be done” and she has been sensitizing the public via a campaign dubbed ‘Fikira Tabia and Hisia.’