NYERI, Kenya, Sept 30 – Mental health is an integral and essential component of health. As such, the promotion, protection, and restoration of mental health is a vital concern of individuals and communities across the world.
With the rapid social changes, human rights violations, stressful work environment, gender discrimination among others, mental health appears to be under the microscope now more than ever. In some parts of the country, however, little effort appears to have been put towards addressing mental health illness and more so within rural villages in Kenya.
The Universal Health Care Coverage (UHC) Pilot program in Nyeri offered free medical services for one year in 2019/2020 and Community Health Volunteers (CHV) received the much-needed boost of training and support.
The impact of this support has helped CHVs who dedicated their energy and time to create awareness on mental health within rural communities. This has had a significant impact as they help families and patients seek medical attention.
In Kaharo village, Mukurweini Constituency, Nyeri County, Joyce Githaiga is no stranger.
As a community health volunteer, she has dedicated her time to supporting families facing stigma and battling mental health issues by providing access to critical services.
Githaiga has been a CHV for six years after receiving training on mental health services at the Catholic Organisation (Caritas), ever since, she has dedicated her life to advocating for the rights of persons with mental health challenges.
“I underwent mental health training and became passionate about helping my clients, it has been an uphill task for me but I have seen progress,” Said Githaiga.
Before the COVID-19 pandemic struck the country, Githaiga facilitated 30-day long support group sessions for her 34 clients by keeping track of their wellbeing and progress during and after the meetings.
Most CHVs are attached to a Health facility where they can work with medical personnel and also refer any cases they are not qualified to attend to.
For Githaiga, Kaharo Health Centre is a fortress that doubles up as a safe space where people can speak freely and share their experiences on their daily struggles and triumphs.
“Bringing my clients together was not easy, because each has their own unique challenges, most of them took time to trust me, and following up with them built trust,” she noted.
One of her achievements is being able to work consistently with at least 32 people in her local community yearning for her mental health services.
One of the cases she has been dealing with is a case of a young woman, code name JW, who has been diagnosed with mental illness.
Githaiga explained that JW, a mother of four young children lives with her grandmother after her parents abandoned her.
“Some criminals take advantage of her and the fact she is sexually active impregnate her and leave her to raise the children, with no support. The cycle of abuse and neglect continues,” she said.
She has attempted to take JW to the hospital to seek family planning options but her grandmother’s religious beliefs have barred her from accessing medical attention.
“I once convinced JW to go to the gynecologist, in Mukurweini, and we organized an appointment for her to get some family planning, and she agreed. But as we were on the waiting bay, her grandmother told her she would be infertile and she panicked, I had to chase her around the hospital trying to catch her,” she said.
Unable to convince JW to get any family planning, Githaiga alongside others in the community have been forced to assist her where capable in raising her children.
Another patient is a young man who has tethered himself to Githaiga refusing to even leave his house if not accompanied by her.
“Every month I have to visit him to ensure he gets a haircut and takes a walk around the village for exercise before taking him back home,” she said during an interview with Shahidi News.
Another challenge for Githaiga is a follow-up on medication and doctor appointments. She noted that when anti-psychotic or anti-depressants medication runs out at the health center, most of the patients cannot afford to buy from private chemists in Mukurweini town.
“We need these medications to be affordable in the health facilities in case of refills because many of these patients have no steady sources of income to support themselves or purchase medical bills,” she said.
She explained that without money for basic needs, they are unable to spend on their medication and they have no social support to get these needs.
Githaiga is now also wearing an entrepreneurial cap, after starting a community soap-making business to help them make some money in order to live a decent life, however, most of them spend their money shortly after selling the products.
Another noble initiative was buying the patients day-old chicks to give them some routine and structure as well as income, unfortunately, this too failed as most abandoned the project by eating the chicken.
One significant challenge she is facing is a growing number of suicide and depression cases during the COVID-19 pandemic.
Githaiga recalled how she has lost close friends to suicide, as the number of cases of depression continue to rise in the rural village.
The incidents in Kahora village offer a glimpse at the growing numbers of Kenyans committing suicide in the country. In the first 10 days of August, Nyeri County reported at least 30 cases of suicide which would average three people a day.
According to data released by the County Police Commander Adiel Nyage, Mukurweini and Nyeri town Constituencies are the worst hit with the majority of the cases being men (25) and five women.
Nationally, Nyeri County ranked among the top five counties according to data released by the Directorate of Criminal Investigations (DCI) in July 2021
Githaiga said the biggest challenge in addressing mental health is stigma and lack of intervention measures at local health facilities.
“People with mental health issues do not know they have a problem and even when they seek medical attention, they have to be referred to other facilities to see specialists,” she said.
While she plays a crucial role in mental health awareness in her village, the role of specialists is crucial in supporting her work.
Data from the county government reveals that there are three psychiatrists distributed at KNH Othaya annex, County Referral hospital, and Karatina Level 4 hospital.
Three psychologists were stationed in Mukurweni level 4, the County referral and the Karia Rehabilitation facility, and five psychiatric nurses.
Nationally, there are over 6,000 counseling psychologists according to the National Secretary of the Kenya counseling Psychological Association, James Mutitu.
“We have psychologists in the country but a lot more needs to be done to address mental health,” Mutitu said.
He confirmed that 134 counselors were employed on a contract basis by the government and deployed to the counties to address mental health during Covid 19.
However, after their contracts ended in June 2021, their fate hangs in the balance, as counties are yet to offer them any terms of engagement.
“Psychologists are ready to work but they are not recognized in the Public Service, and without a structure of engagement the public is missing out on the expertise they offer in mental health” he noted.
A lack of psychosocial interventions to diagnose and treat anxiety and depressive disorders in society in an affordable and timely manner.
This is the expertise of counselors and psychologists who can offer therapy and interventions for anxiety and depression before it progresses.
While cases of psychosis and serious mental health issues can be addressed by psychiatrists, unfortunately, they have a medical approach that is different from what psychologists offer.
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