When the body of a 23-year-old man was found dangling from the window of the mental patients' ward at the Nyeri county referral hospital, residents reeled with shock at the height of negligence existent at the facility.
The family blamed the facility for failing to protect their son, who had already tried to commit suicide at home.
The patient is said to have hanged himself using a pair of trousers inside the strong room in the mental ward.
This needless death of a mental patient who was supposed to be under suicide watch exposes the rot that has eaten into the country's public health infrastructure particularly in relation to mental health services.
In many parts of the country, grim statistics paint the picture of a mental health capacity that is virtually non-existent in public health programmes across the counties.
The World Health Organisation estimates that about 800,000 people die by suicide each year.
According to a research paper, "Providing Sustainable Mental Health Care in Kenya" by Professor David Ndetei of the University of Nairobi and Dr Ana-Claire Meyer, there is a dramatic shortage of human and other resources to effectively care for these disorders.
In Nyeri, Meru and Murang’a counties, health department officials were unable to reveal how much money is spent on drugs to treat mental illness. The counties also face a shortage of psychiatrists, nurses and other staff to take care of the patients who require close monitoring.
A report adopted by the Nyeri county assembly described the psychiatric section as the most neglected. The discrepancies in the wards range from poor infrastructure and lack of drugs to dilapidated buildings.
At the Murang’a level five hospital, the psychiatric ward accommodates 10-15 inpatients, but there is an addition 10 beds reserved for other patients.
According to the hospital’s superintendent Doctor Leonard Gikera, there are two nurses per shift (for eight hours), who are running the ward.
When the Nation visited the hospital on Thursday, family members of the patients told the Nation that they were satisfied with the medical services offered at the facility.
“I have a patient here and he has been well attended to and in fact he is doing well. I’m very grateful to the hospital management for catering to the patients’ wellbeing,” James Mwangi, a father of one of the patients said. However, hospital staff who talked to Nation on condition of anonymity said the ward lacked personnel as only three nurses were equipped with psychiatric knowledge.
The Wajir county psychiatric unit is yet to be fully operational two years after it was commissioned. The unit was commissioned in 2016 before starting operations later on in that year, but it is yet to meet the standards of a fully functional mental clinic.
The unit has a capacity of 20 patients comprising of 12 male patients and eight female patients. In an interview with the Nation, the hospital clinical officer in charge Robert Ogalo said that the clinic is only offering outpatient services. He added that they were yet to begin the in-patient services due to lack of personnel adding that the rooms are not yet conducive to allow for admission.
In Meru, the only in-patient psychiatric unit in the upper eastern region is overstretched with the 16 bed facility sometimes having more than 40 patients. An official who spoke to the Nation said it is difficult to turn away or refer patients with mental conditions leading to congestion. The facility is also manned by seven nurses against a need of 13.
“Out of the seven nurses, only two have specialized training in handling psychiatric conditions. The shortage of nurses in the unit has been blamed on a countrywide challenge,” the official said. The unit often runs out of drugs, forcing medics to send patients to chemists.
“Some patients are brought by police and have no relatives to buy drugs. In this case we have to source drugs from other centres or contribute from our pockets to buy the drugs. At times, we have had to pay fare for recovered patients when they are discharged,” he said.
The official said there was need for allocation of more resources to expand the bed capacity and hire more specialised nurses.
According to the Mental Health Atlas 2017 released by WHO, the ratio of mental health workers can be as low as 2 per 100,000 people in low income countries, compared to more than 70 in high income countries. It is also estimated that 540 million people suffer from mental disorders, with almost three-quarters of them living in middle and low income countries.
Mental disorders include those affecting mood, thinking and behaviour. It accounts for 13 per cent of the global disease burden and WHO project this will rise to 15 per cent by 2030.
Reporting by Irene Mugo, Bruhan Makong, Manase Otsialo, David Muchui, Grace Gitau, Ndung’u Gachane and Vivian Jebet