Effective interventions exist for mental ill-health

This past week, the Kenya Psychiatric Association (KPA) hosted a conference that brought together mental health experts from the entire African continent.

The theme of this conference was “Implementation of mental health research for policy development in Africa”, and many experts made presentations exploring themes related to translating research findings into policy and programmes.

This theme resonates strongly with ongoing efforts across the continent to address the huge and rising problem of mental ill-health among our people.

Due to increasing focus on mental health in research, and the growing evidence that mental ill-health imposes a great burden on the day to day lives of our people, many African governments have arrived at the realisation that indeed there is no health without mental health.

In Kenya, we have demonstrated through research the great burden of mental ill-health in our communities. In a recent study led by a colleague in Eldoret, we demonstrated that close to half of a mostly rural population in western Kenya had suffered at least one mental disorder in their lifetime. The proportion of participants who had attempted suicide was also very high, reaching a rate of one in every six people.

Previous work by colleagues all over Kenya had shown that up to half of patients visiting hospitals for general medical reasons actually had depression of varying severities. Other work has revealed that a huge number of Kenyans have lived under such difficult conditions that they suffer from post-traumatic conditions that are having a serious impact on their lives.

There is absolutely no doubt that mental ill-health is a large contributor to illness and even death in this country, as in most of Africa.

The World Health Organisation and other agencies estimate that depression is one of a raft of non-communicable diseases that are wreaking havoc in the lives of Africans. Indeed, the upcoming World Health Day is themed around depression in recognition of the rising importance of this condition and its impact on all aspects of our lives.

The missing link is a deliberate effort from our governments to address these problems conclusively. The conference last week was organised to deliberate on efforts to use this knowledge to develop strategies and policies necessary to deal with the problem of mental ill- health on the continent.

Clearly, innovative plans are required in this field, as demonstrated by presenters at the KPA conference. These include revising the training of all health workers to ensure they learn how to recognise and initiate appropriate management for common mental disorders, as well as deliberate efforts to train more mental health workers.

Identifying priority mental health interventions and directing resources appropriately is another strategy that can begin to dent the huge burden of mental ill-health.

We must also continue to educate the public and policy makers on the importance of addressing mental ill-health through promotion of healthy lifestyles and prevention of obviously risky practices. Interventions to improve care of children even before they are born, immunisation campaigns, promotion of good nutrition and a properly structured education system are seemingly peripheral strategies that have huge mental health benefits downstream.

It is indeed unfortunate that every time we hear of mental health interventions we think about clinical care of people with the most severe mental disorders like schizophrenia or bipolar disorder. With this mindset, we assume that any intervention can only have temporary benefits and would cost huge sums of money to implement. The truth is that only a small percentage of mentally ill people roam the streets looking unkempt and behaving in a grossly disorganised manner. A majority of people with mental illness are struggling in silence, plodding through life not knowing that solutions exist for their problems.

Kenyan and African psychiatrists are today telling the people that there also exist interventions that actually work and need not break the bank.

Lukoye Atwoli is Associate Professor and Dean, Moi University School of Medicine [email protected]