Let’s decriminalise signs of mental illness

They say that when a person only has a hammer, all problems look like nails.

One of the biggest problems in Kenya is over-using legal solutions in all spheres of decision-making, and the under-involvement of other professionals in designing social and political interventions.

All problems in Kenya have been conceptualised in legal terms, with solutions involving changes in statute law or the Constitution.

An area that has suffered this approach is mental health.

When we see people getting hooked to dangerous drugs that cause serious physical and psychological problems, our first reaction is to suggest more stringent laws to get them off the streets and into our legal justice system, often ending up in jail.

UNDERLYING PROBLEM

We do this despite the overwhelming evidence that most people who experience problematic substance use have an underlying psychological or social problem that is most likely amenable to any of the various interventions available in the mental health field.

The result of this approach is that our remand centres and correctional facilities are full of people arrested for possessing or using certain ‘banned substances’.

A significant proportion of these people will have only been experimenting with the substance, and their incarceration results in unnecessary loss of productivity to the economy.

Further, for those with underlying psychological problems, incarceration does little to improve access to needed medical, psychological and social interventions that would have dealt with the problem and forestalled future complications.

ATTEMPTED SUICIDE

Another historically criminalised feature of mental ill health or psychological distress is attempted suicide.

For a long time, and in many countries across the world, legalistic interpretation of the status of a person in law has led to the determination that attempted suicide is a serious criminal offence for which convicted ‘offenders’ are liable to punishments, including jail terms.

Any person with a non-legal bent of mind will tell you how ridiculous it is to arrest someone who has tried to kill themselves and, instead of getting them urgent medical attention, send them to jail for several years to ‘teach them a lesson’.

MENTAL DISTRESS

If anyone had asked mental health experts they would have been told that the vast majority of people who try to kill themselves have serious mental illness or psychological distress.

By the time someone is overcoming the inbuilt survival imperative and makes a serious attempt on their own life, they have reached the end of their coping ability and feel that suicide is the only available solution.

Jailing them or even taking them through a prolonged trial only exacerbates these feelings, and increases the risk of a completed suicide later on.

It is time we started looking at people’s asocial behaviours through a variegated lens that goes beyond legalistic instincts to involve social, behavioural, and mental health experts.

Lukoye Atwoli is Associate Professor of Psychiatry at Moi University School of Medicine; [email protected]