Sunday, October 16, 2011

Mental Health: Well done, but we can do better

Sunday Nation 16 October 2011

Last week on Monday I attended the World Mental Health Day commemoration at Mathari Hospital together with colleagues from all over the country. Workers of all cadres at the hospital put up quite a show, and included both the patients and the neighbouring community in the organisation of the event. The minister for Medical Services graced the occasion, despite having just arrived in the country from an official trip to India.

During the event, guests were conducted on a guided tour of the hospital, and one could not help but notice the great enthusiasm with which the management and board of the hospital are going about improving facilities and services at the hospital. Many of the wards were under renovation, the grounds were neatly kept, and the staff appeared to have some intrinsic motivation as they went about their duties.

All these are commendable achievements in the wake of international media revelations of patient abuse and inadequate services to clients at the only national referral hospital for mental health in the country. It is difficult to blame the staff who are doing the best they can under the most difficult of circumstances to serve the most neglected segment of our society.

It is, however, important to note that whatever little has been achieved by this facility has been done under the most formidable odds possible. The national hospital operates with the budget of a district (or sub-county) hospital, and is graded as Level 4 as far as allocation of resources is concerned. The buildings being spruced up at the facility were built in the early 20th century, and most cannot be certified for human habitation if they are properly inspected.

Indeed, the hospital board seems to have realised just this, and during our visit to the hospital they presented to the minister and Afya House officials a blueprint for a new hospital to serve as the national referral facility for mental health.

This, in my view is the crux of the matter. The minister promised to do all in his power to ensure that the master-plan was implemented, and undertook to present a Cabinet briefing to his colleagues to initiate the sourcing of funds to make it a reality. He also promised to advocate for increased allocation to the hospital, and to mental health services in general, to better address the mental health of our nation.

In my opinion, we must hold the minister, and by extension the entire government, to account over this promise. We must interrogate the government’s spending priorities to ensure that mental health is included at all levels of health expenditure, and that mental health programmes are designed and implemented all over the country.

We must do these things not because any particular individual stands to benefit from the resultant improvements, but because it is the right thing to do.

Better funding

We must insist on better funding for mental health and health programmes because no nation in the whole world has ever prospered without ensuring that the whole population has access to the highest quality of health care services available within its borders.

We must recognise that failure to improve our mental health services guarantees several generations of mediocre leadership and under-achieving technocrats, leading to continued retrogression and needless suffering.

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and lecturer at Moi University’s School of Medicine

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