About 100 patients climbed over the wall at the Mathari Teaching and Referral Hospital in Nairobi. Many reports linked the incident to the country-wide doctors’ and nurses’ strike that began on the same day. The fact is that even without the strike, the hospital was already understaffed, overcrowded, and underfunded. The whole country has only 88 psychiatrists.
This is the second time since 2013 that patients have run away from the hospital. The first time, about 30 patients broke out, complaining about overcrowding and overdosing. As was the case in 2013, the hospital once again asked the public to help take the patients back.
A visit to the hospital by members of the National Assembly’s Health Committee in February this year revealed that a lot needed to be done and the members promised to raise the issue in Parliament.
In May, the Ministry of Health launched a mental health policy, which, among other things, aims to reform the system by addressing issues such as lack of leadership in the sector.
The reforms include appointing a board, funding, training of service providers, and public awareness.
While these may sound like laudable commitments, evidence from other African countries shows that such a policy alone might not be sufficient. The Ghanaian government launched a mental health policy, complete with a mental health board, in 2013. However, the policy has yet to be implemented.
In October this year, the Accra Psychiatric Hospital, one of the main referral hospitals in the country, sent 200 patients home after nurses went on strike due to poor working conditions. Although this pushed the Ghanaian government to provide some funding for the hospital, it did not lead to prioritisation of mental health in the country.
Unfortunately, in much of Africa, mental health care is limited to placing patients in institutions, fact-finding missions by government, or increased funding. No efforts are made to comprehensively address the issue.
The society faces rising mental health challenges, often triggered by the increasing stress brought about by modern life and demographic changes such as urbanisation. If we are to address these challenges, it is essential that we move away from the current focus on curation and instead put more emphasis on prevention.
African governments should invest in continuous public awareness to help drive and shift conversations from institutionalisation to community mental health systems.
In Kenya, the devolved system should ensure that mental health services are available in primary health care facilities in all counties. Community mental health volunteers could help identify and tackle mental health issues when they first start and help reduce the burden on referral hospitals.
We have heard all the fine words, but now it is time African governments followed with actions, implementing all aspects of existing policies in collaboration with non-governmental organisations, health care workers, activists, community health volunteers, caregivers, and those diagnosed with a mental health condition.
Unless this is done, mental health will remain at the mercy of knee-jerk responses fuelled by the vicious cycle of work boycotts, patient breakouts, and government band aids in times of crisis. Everyone has a stake in ensuring that we address mental health. And it is our responsibility to be part of the solution.
Ms Wafula, a 2016 Aspen fellow, is the executive director of the My Mind, My Funk mental health information and support hub. firstname.lastname@example.org