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Concern over rising mental illnesses in Kenya as medics turn to drugs and substance abuse

By George Kebaso
Thursday, October 10th, 2019

About 25 percent of Kenyans are suffering from different forms of mental illnesses according to a survey done by a group of mental health experts.

The study, according to Associate Professor of Psychiatry at Moi University's School Medicine Lukoye Atwoli, shows that a huge number of Kenyans who visit health facilities, besides other diseases they are suffering from, also face the challenge of mental health illnesses.

"Half of Kenyans who suffer from other diseases are also facing the challenge of mental disorders,” he said yesterday during celebrations to mark the World Mental Health Day in Nairobi.

In a government statement, the Ministry of Health estimates that 42 percent of Kenyans attending general medical facilities have symptoms of severe depression; an indication of mental illness in the country is on the rise.

“The prevalence rate of common mental illness which includes depression and anxiety disorders is about 10.3 percent,” the statement reads in part.

The World Health Organisation (WHO) estimates of 2016 show that age-standardized suicide mortality rate in Kenya stands at 5.6 percent for 100, 000 of the population.

Further, the MOH estimates that suicidal thoughts which are associated with depression lifetime prevalence stands at 7.9 percent.

Globally, over 800, 000 die of suicide annually which equates to one suicide every 40 seconds.

Suicide is the second leading cause of death between 15-29-year-olds.

For each suicide, approximately 135 people suffer intense grief or are otherwise affected. This amounts to 108 million people per year who are profoundly affected by suicidal behaviour.

The situation is complicated by the high stigma attached to suicide and suicidal behaviour and legal barriers that deter people from opening up and access care.

But even more worrying is the revelation that abuse of drugs and substance use is highly prevalent among healthcare workers due to burn-out and long hours of work. Prof. Atwoli told People Daily, this is a potential danger for patients seeking medical help.

“Doctors with harmful substance use are potentially harmful to patients since their decision-making capacity is impaired,” Atwoli said.

He said for every suicide, about 20 people make a suicide attempt.

“Suicide has a devastating impact on families, friends, and communities. Every life lost represents someone's partner, child, parent, friend or colleague,” he added.

During a one-day symposium at Nairobi hospital early in the week, it was revealed that the number of healthcare providers struggling with depression associated stress in the country could be higher than imagined putting lives of millions of Kenyans seeking medical attention at risk.

The symposium dubbed; Moral Injury Symposium 2019, doctors expressed concern that the wellbeing of a patient in the country is facing challenges due to huge unhappiness among the treatment fraternity.

Even though there are no local studies to show the severity of this problem among healthcare workers in Kenya, conservative estimates of a study conducted in Sub Saharan Africa shows that between 40 to 80 percent of physicians, nurses, and other healthcare providers are suffering from depression or burnout.

Renowned physicians; Dr. Jacquelene Kitulu, Kenya Medical Association (KMA) President, and Dr. Mucheru Wang’ombe, a consultant psychiatrist attributed workload; shift work, long working hours, poor infrastructure, inadequate resources and shortage of staff to be the main factors.

“We know that a sick doctor; an unhappy doctor and an unappreciated doctor, is a dangerous doctor. Therefore, there is a need to put in place a system that will ensure that doctors and other healthcare workers are happy. For when they are happy, their patients are also happy,” Atwoli said in a media briefing.

He said depression, classified as Major depressive disorder (MDD) by the American psychiatric association (APA, 2013), a common and serious illness that ischaracterised by an abnormally low mood, must be dealt with immediately.

“We need a system where doctors have time and are accessible to recreational facilities, to exercise and enjoy themselves in a healthy way; someone to talk to, and an intentional work-life balance,” he added.

And of more concern, to address this problem described as silent killers, die to the stigma associated with it, healthcare providers have turned to heavy drinking and abuse of drugs they are supposed to dispense.

In relation to this, Dr. Kitulu said that many doctors due to the secrecy of their suffering, they don’t have doctors. “The issue here is not about their confidence, but many doctors for fearing discrimination that comes with the tag of ‘miracle monster’ have refused to step out, and be helped,” she said.

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