The World Mental Health Day will be observed on October 10. According to the World Health Organisation, this day has been set aside to raise public awareness of mental health issues.

For most people, all things mental health barely make a bleep on their radar unless there is direct personal involvement.

“Mental health is multidisciplinary and it is a triad of the social, physical and spiritual wellbeing of an individual,” explains Dr Nelly Kitazi, the medical superintendant at the Mathari Hospital, the only referral hospital in Kenya that works with mental health patients.

“People are quick to call these patients ‘mad.’ That is wrong. They simply present different behavioural and neurological disorders that are all classified under mental disorders and it is also important to note that these are disorders not diseases,” she stresses.

Locally, these disorders cover a wide range. Schizophrenia and bipolar mood disorders termed as psychosis are common cases, as are anxiety disorders such as panic attacks and post-traumatic stress disorders.

Another common one is organic brain disorders, and currently there are over over 300 patients.
“These are illnesses that occur in the body but cloud the mind. Examples are cerebral malaria, dementia, substance abuse and addiction among others,” says Dr Kitazi.

Eating disorders, sleep disorders and psychosexual disorders such as voyeurism are other examples of common mental disorders.

Doctor Kitazi ranks stigma as the leading challenge facing these patients. She says, “A simple example, when you meet an individual on the street who is disturbed, what is your natural reaction? You can imagine then what happens within families.”

She adds that the stigma is also aimed at the doctors. “We are often called ‘daktari wa wenda wazimu,’ literally doctors for mad people; many people imagine we must be in the same mind frame as our patients to be able to deal with them. They forget that we are actually trained medical doctors who decided to specialise in this field.”

Discrimination on various fronts is another challenge. Dr Kitazi zeroes in on the hiring process.

“Many questionnaires ask, ‘Have you ever suffered from mental illness?’ That is all right if it is asked in a positive way but this is often used to deny people who live with mental disorders sustenance. In many of the cases, all that is required is proper medication and the individual can function just like any other.”

This applies to inheritance as well, where such individuals are left to fend for themselves instead of having a guardian appointed to look after them.

Some mental health disorders such as suicide and schizophrenia are criminalised, a situation which Dr Kitazi says only makes matters worse.

“A schizophrenic patient for instance often hears voices telling him or her to jump or throw stones or any other number of things. The emphasis should be on understanding the underlying factors with this individual.”

Though the rights of mental health patients are protected in the 1991 revised Mental Health Act, follow up action is lacking right from the top.

Additionally, funding and resources for the 700-bed capacity Mathari Hospital falls way below the required level but the hospital has continued to offer services and even expanded its servics beyond those of mental health.

Since late 2008, it has been providing other services to the public and includes a diabetic clinic, a mother and child and a wellbaby clinic, VCT, PMCTC and PITC services, drug rehabilitation and a host of other services.

“We realised that there is a very large community in and around the hospital who haDno access to some of these facilities and had to travel far for treatment. The uptake has been impressive,” says Dr Kitazi.

The well baby clinic for instance, saw 6,747 cases in 2008 with numbers rising to 8,143 patients at the end of 2009.

As Mathari Hospital expands its services, this step has helped it handle another challenge, that of public education and awareness on mental health issues.