Monday, July 30, 2012

Invest more in mental health research

Sunday Nation 29 July 2012

Over the past two weeks, I participated in two mental health conferences that are of particular relevance to our situation in Kenya. The first was the Kenya Psychiatric Association’s Annual Scientific Conference in Kisumu.

Mental health workers from all over the country interrogated the place of mental health in national development, specifically its impact on Vision 2030. The meagre budgetary allocation to health (amounting to 5.8 per cent of national expenditure) and the practically non-existent mental health vote were some of the key concerns raised at that meeting.

Participants urged the government to increase health expenditure towards the Abuja target of 15 per cent of national expenditure, and also to raise the mental health expenditure from the current 0.01 per cent of health expenditure. Recommendations were made on improvement of infrastructure, particularly upgrading Mathari Hospital to national referral status.

The state of this hospital is currently deplorable, and those working there pointed out that due to perennial underfunding, patient clothing and linen is scarce, sanitation is difficult to maintain, and food and medications are inadequate. Indeed, the medical superintendent of the facility reportedly resigned in frustration a few days before the conference.

The second meeting I attended last week was a World Health Organisation conference bringing together collaborators in the World Mental Health Survey Initiative, and was held in Brussels, Belgium. Leading mental health researchers met to share current knowledge on the state of mental health in the world. The burden of mental disorders was noted to be rising worldwide, including in developing countries, and it was agreed that global mental health funding needs to increase exponentially to meet this need.

A key finding concerned the role of mental conditions in increasing the risk for physical illnesses. For instance, a clear link was demonstrated between depression and a heart condition that is the commonest cause of death in many Western countries. Causative links between mental disorders and other illnesses such as diabetes mellitus, peptic ulcers and even hypertension suggest that mental illnesses must now be managed as part of a prevention strategy for chronic medical diseases.

A key observation for me at this meeting was that African countries are grossly under-represented in mental health research. This is due to the meagre allocations to research in most African countries, coupled with the already inadequate health care funding by African governments. It must be appreciated that without health research all that is left is the experience of the clinician, which can be very capricious even with the most experienced doctor.

Health research helps us to discover what the priority problems are in our country, and what proven solutions may work in dealing with these problems. With political will, it is possible to invest in health research and translate research findings into clinical practice, gradually improving the health of our people.

What little research is available in this country indeed suggests that we are facing a huge burden of chronic diseases, many of them related to mental health. According to the emerging evidence, unless mental disorders are addressed, they will continue to complicate efforts to deal with other medical conditions, as well as the concomitant social and economic challenges in developing countries.

Dr Lukoye Atwoli is secretary, Kenya Psychiatric Association, and lecturer, Moi University School of Medicine.; twitter @LukoyeAtwoli

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