Last week, the Associated Press reported on the deplorable state of Kenya’s only psychiatric hospital — where locking patients up and over-drugging them appear to be the norm. Things are so bad, recently 40 patients actually escaped from the hospital.
Mental health treatment continues to lag — sometimes quite severely — in under-developed countries throughout the world. Many countries in Africa continue to treat people with a mental illness as though they had leprosy or some other inexplicable, communicable disease.
Because so little is understood about mental illness by some of the peoples of these countries, family members are often outcast and given over to well-meaning — but severely understaffed and under-resourced — professionals. This is of little surprise when poverty is so rampant in countries like Kenya.
The Mathari psychiatric hospital — which has 675 patients in its general wards — lies close to the sprawling Mathare slum district of Nairobi. Kenya’s only psychiatric hospital also appears to confine and immobilize many of its patients, using drugs that put them in a comatose-like state.
Worse, if the hospital is full (and it nearly always is), family members apparently get their loved ones locked up somewhere else anyway, “Currently those who cannot access the right rehabilitation services are locked up and subjected to very inhumane treatments by their families and communities,” according to Edah Maina, the chief executive officer of the Kenya Society For the Mentally Handicapped.
But you know things are bad when your patients need to plan a prison-break to leave your “treatment” facility.
The Carter Center’s Janice Cooper, Ph.D. said this of Liberians, another poverty-stricken African country: “To most Liberians, people with a mental illness are useless for society. Some think that mental health conditions are contagious, or that victims are under the spell of witchcraft.”
The Carter Center’s Mental Health Program did something about the poor mental health treatment in Africa. It teamed up with Georgia Tech’s Computing for Good Initiative to help the Liberian government monitor the country’s mental health needs and train local mental health clinicians to help work reduce stigma and discrimination against mental illnesses in that country.
Sadly, there’s only so much money to go around. Perhaps if it works in Liberia — it’s a 5 year program — it can act as a model for other African countries.
But back in Kenya, this are not so good at the country’s sole psychiatric hospital:
‘‘They should be in a program … one that they consent to and is not forced on to them; and among other things, a program that ensures their continued productivity as members of society, not one that immobilizes them through use of outdated/outlawed drugs that turns them into mere zombies,’’ said Maina.
We couldn’t agree more. In the U.S., we call it “community treatment” — treat patients as close to home as possible. This resulted in more outpatient services being delivered and the closing of many state psychiatric hospitals across the country throughout the past four decades. It has also led to greater use of group homes (for people who need more supervised daily care) and day treatment programs (for people who need structured daily activities and can’t work because of their mental illness).
Programs like this can be rolled out in Africa, too, but it’s no wonder they haven’t. If we recall Maslow’s Hierarchy of Needs, we’re reminded that before we can turn to treatment for mental illness, we need basic physiological needs to be met — food, water, sleep and shelter.
And in countries like Kenya, such basics are sometimes hard to find.
Read the article: Kenya’s mental hospital drugs, confines patients
Watch a video: Locked Up In Kenyan Mental Health Hospital