Monday, December 30, 2013

Blow as mental health division is scrapped

I am once again sorry for delayed posting of some of the December articles, beginning with this one that appeared in the Sunday Nation of 8th December 2013. I was unable to update this blog as regularly as I'd like due to several reasons that would make the subject of independent posts in their own right! Here goes!

Blow as Mental Health Division is scrapped

By Lukoye Atwoli
Sunday Nation 08 December 2013

Last week, a friend working at the Ministry of Health headquarters, Afya House, sent me an email informing me that with the stroke of a pen, the head honchos in the ministry had scrapped the Division of Mental Health and instead replaced it with a nondescript unit with an unclear mandate. It is unclear what is to happen to positions in the division such as that of the director of mental health who was the top-ranking civil servant mandated to develop and implement mental health policies, strategies, plans and programmes across the country.

If it is, indeed, true that the division has been scrapped, the implications of this seemingly innocuous move are enormous.

Firstly, it is of course inconceivable that a unit in the ministry of health would have any direct budgetary allocations to carry out its own programmes. Obviously this means that the recent promises and proclamations by government that they will enhance mental health funding and improve mental health services across the country cannot be taken with any degree of seriousness.

Secondly, and perhaps more importantly, the move amounts to a demonstration of high-level self-defeating impunity. The Mental Health Act of 1989 provided for the setting up of the Kenya Board of Mental Health, with the Division of Mental Health serving as the secretariat of this board. The director of mental health was meant to be secretary to this board, and chief mental health specialist in the country. The holder of this position would be the government’s go-to person whenever mental health advice was needed, as well as being the person responsible for ensuring that the government’s mental health policies are properly implemented.

Today, the Act is yet to be fully implemented, and there is no mental health vote in the budget.
The Mental Health Board has not been fully facilitated to fulfill its mandate, and mental health services remain rudimentary in most parts of this country. And now, to add insult to injury, the government appears to be moving with speed to dismantle even the few gains made over the decades in this delicate field.

The Cabinet Secretary for Health, Mr James Macharia, needs to move with haste to correct this situation if he knows what is good for the ministry. He must establish a vote for the Mental Health Division within the Health budget and, as per earlier recommendations, this needs to be significantly higher than the current 0.01 per cent of the health budget.

He needs to advertise and competitively fill the position of director of mental health as required under the Constitution. He must complete the process of developing Kenya’s Mental Health Policy which has stalled in the corridors of Afya House for decades. He must institute programmes to deal with mental health crises in this country, including substance use, illness-related suicides, homicides, accidents and violent crimes.

The Cabinet secretary needs to establish a fully staffed and provisioned Kenya Board of Mental Health, with a functioning secretariat as envisaged by existing legislation. Funds must also be set aside for supportive supervision and mental health research in order to ensure the evidence base for decision-making is broader and well-supported.

In short, Mr Macharia should not only reverse this illegal and immoral decision if, indeed, it has already been made, but also implement measures to fully operationalise the existing mental health legislation. 

Dr Lukoye Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine.

1 comment:

  1. The law must be taken as soon as possible, otherwise what to do with people who are in psychological disorder, do unbearable things . Because of this, suffer not innocent people!!!


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