Tuesday, June 25, 2013

State must fulfill mental health pledges

By Lukoye Atwoli
Sunday Nation 23 June 2013

Just over one week ago, the Kenya Psychiatric Association held its most successful annual conference yet.
With an impressive attendance representative of the mental health field in this country, the ground was set for presentation of ground-breaking issues in research and practice. Psychiatrists, psychologists, social workers, nurses and students in mental health were among the participants, and the discussions, centering largely on the area of psychological trauma, were very stimulating.

For the first time in the recent history of KPA, the policy leadership at the ministry of Health participated actively, and made specific pledges that will go a long way in improving the mental health of our people. The Cabinet Secretary, who was held up in Cabinet and budget meetings, delivered his speech through the director of mental health at the ministry.

The highlight of his speech was his commitment to deliver results in four main areas.

First, the Cabinet Secretary pledged to strengthen leadership and governance in mental health in this country. He promised to establish a Directorate of Mental Health and Substance Abuse to coordinate mental health with other important sectors such as education, labour and the legal justice system, among others. He also indicated that the draft Mental Health Policy and the Mental Health Bill will be expedited in order to provide a policy and legislative framework for mental health activities.

The current Mental Health Act of 1989 provides for a Kenya Board of Mental Health to oversee mental health activities in the country. For over 20 years, this board is yet to be properly constituted, and there is no vote for it in the ministry of Health budget. The Cabinet Secretary indicated that this anomaly will soon be corrected, and the board will be constituted and facilitated to begin work expeditiously.

Secondly, the Secretary has indicated that mental health services will soon be available in all 47 counties through an initiative in which mental health will be integrated into comprehensive health services at all levels of care. One hopes that this will include ensuring that all county referral hospitals have a mental health department to carry out promotive, preventive, curative and rehabilitative mental health activities.

Thirdly, we were informed that national Mental Health Promotion and Disease Prevention Programmes are on the way. These will incorporate promotion of healthy lifestyles, as well as prevention of suicide and child maltreatment in order to improve the population’s mental health. Programmes such as these must be evidence-based if they are to show effectiveness.

Finally, the Cabinet Secretary promised to strengthen and improve mental health information systems and create a research infrastructure for mental health. An easy win in this regard will be to incorporate mental health indicators in the health management information systems that are already in existence.

As far as research is concerned, it is noteworthy that the Kenya Medical and Research Institute (Kemri) has already established a mental health research programme. Those of us working outside Nairobi will also be happy to host a Mental Health Research Institute to provide a strong evidence base for mental health interventions.

The government needs to look beyond the usual approaches to generate truly innovative solutions to mental health problems. 

Dr Lukoye Atwoli is a senior lecturer at the Moi University’s school of medicine Lukoye@gmail.com; Twitter @LukoyeAtwoli

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