Alarm as Homa Bay records surge in mental health problems

Had Collins Otieno, a resident of Gwassi in Homa Bay County, shared his problems with family and friends, he would have been alive today, his family says. But his silence led him to depression, and eventually suicide, notes Pastor Kenneth Ouma, who was living with Collins as his adopted son.

Collins,24, was found dead in his house on July 8. Mr Ouma says Collins kept to himself and never shared his problems. In April, he lost his house after a rockslide hit his village.

“Had he told me the challenges he faced in life, I could have looked for ways of helping him. Unfortunately, it is too late for that,” Mr Ouma says.

Mr Ouma now wants institutions to create awareness about mental health to reduce the increasing number of mental health issues and suicide deaths being reported in the county.

“There is a lot of emphasis on helping girls and women. Boys and men have, however, been neglected. The rising cases of depression among this group are alarming,” Mr Ouma says. 

Dr Amos Dulo, the Rehabilitative and Curative Heath Director in Homa Bay, says hospitals are reporting rising demand for mental health services. 

He says some of the affected residents, including civil servants, have turned to alcoholism because of social challenges. “The social challenges include high HIV prevalence, reduced income and poverty,” Dr Dulo says. 

At Homa Bay County Teaching and Referral Hospital, up to 15 people seek mental health services every day, a number that medical staff believe is just a small fraction of the people suffering from mental illnesses in the county. A special clinic has been established at the hospital to handle the cases. 

Ms Margaret Onyango, a psychiatrist nurse at the clinic, says some of the people who seek services at the hospital have previously attempted suicide. Others are suffering from mental disorders due to drug-induced complications. “We also handle people suffering from bipolar disorder. Mental health challenges can also be genetic and we see patients whose parents had a history of such challenges,” Mr Onyango says.  

She notes that the common symptoms of mental disorders include insomnia (lack of sleep), restlessness, isolation, lack of concentration, laziness and withdrawal. 

She regrets that some patients seek medical intervention when it’s too late, citing barriers to seeking mental healthcare such as stigma, financial strain, poor awareness, and sociocultural and religious influences.

According to Ms Onyango, some families seek spiritual intervention. “They take their kin to places of worship hoping that the conditions will be cured”. She adds that other people take their loved ones to herbalists, where they are given herbs that mostly do not work. 

 Ms Onyango says an emerging trend where people living with HIV stop taking their antiretroviral drugs is also increasing the incidence of mental disorders. She explains that this happens when the virus affects the brain at a time the viral load is high.  

She says people living with HIV are encouraged to adhere to treatment and a balanced diet. 

Ms Onyango says people with mental disorders are normally introduced to antipsychotic drugs or talk therapy (physiotherapy), or both. 

“Unfortunately, some stop taking the drugs before they recover, erasing all the gains they have made in their recovery journey,” she says. 

The clinic is also struggling with limited resources and staff. It is manned by three psychiatrist nurses, two psychologists and one clinical psychiatrist. 

Meanwhile, some patients from Homa Bay have been referred to as far as Mathare Hospital in Nairobi because of lack of space to accommodate them. 

 Ms Onyango says patients who act violently must be monitored when they are introduced to treatment for the first time. She says medics check on them during the first days to monitor their reaction when near other people. Unfortunately, due to lack of accommodation for such people at the facility, most families are told to seek help elsewhere.   “Besides Nairobi, patients can be referred to Kisii or Kisumu, but most families cannot afford to take their kin to the neighbouring counties; leading to some being locked at home or left to walk in the streets,” the psychiatrist says. 

The mental health clinic is also in need of a system of collecting data to enable doctors to monitor trends and identify solutions for different problems.  

 Homa Bay Health Chief Officer Kevin Osuri says the county government has trained more health workers to handle mental health issues.   Dr Osuri cites a waiver on drugs used by people suffering from bipolar, anxiety and other mental  disorders.  

“We do not charge anything for the drugs. Patients can walk into our facilities and get them for free,” he says.  

Dr Dulo says the devolved unit intends to establish a mental health hospital.

 “We will first engage the community and agree on where the hospital will be set up. Some communities have in the past opposed this, saying some of the patients are likely to harm them,” he says.

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