After huge loss of jobs comes the mental health headache

The last one month has been one of anxiety on who will be on the chopping board as one company after another sends staff home in a bid to stay afloat.

And despite some offering counselling to help absorb the shock, the workers, who have been fired, say that is not enough.

“What counselling? In fact we were told our benefits will be staggered over a whole year. If they had just given me in lump sum, I’d have at least bought a computer and started my own gig,” Mary (not her real name) says.

This is now the everyday reality for thousands of Kenyans being turned away from their jobs without an idea of where their next pay cheque will come from as the impact of coronavirus wreaks havoc on the local economy.

Kenyans barely put anything aside for a rainy day with a savings rate of 6.1 per cent of GDP in 2018, down from 6.5 per cent in 2017 and an all-time high of 11.7 per cent in December 2007.

Many of those who have put something aside, and whose employers managed to offer them terminal benefits, have made a series of bad investment decisions, some of them easily lured by fraudsters who have increased the sale of bitcoin, pyramid schemes and the Kamiti mobile money phone syndicate.

A SURGEE OF ANXIETY

“People are very vulnerable. You have money now and know that you will not get any next month, but still fall for get-rich-quick schemes. Someone tells you, ‘Give me money, I’ll invest in forex and give you a million next month’ and disappears with it. Preparation is key before you let somebody go,” says Prof Lukoye Atwoli, a psychiatrist at Moi University and Moi Teaching and Referral Hospital.

This grim future, he says, is a cause of alarm especially as people continue to lose their sources of livelihood, cooking the brains of Kenyans in a slow fire of depression.

The coronavirus crisis is not coming from people dropping on the streets like the images of plagues in history. It’s coming from the confines of homes, a surge of anxiety that cannot stay at home or keep its social distance and no one seems ready for this great depression.

Health and livelihood give ordinary people anxiety all the time, but with coronavirus, the threat of losing a job is more palpable than contracting the disease.

About 63 per cent of Kenyans are late on rent, thousands behind in their mortgage payments, restructured Sh679.6 billion, and defaulted on Sh366.8 billion. With increasing unemployment, inability to provide for families and economic uncertainty, cracks are fast emerging.

“There are teachers who are practically jobless after schools were closed and they are a huge segment of the economy. We have people whose businesses have gone down. Those who provide domestic services have seen their services unwanted,” Prof Atwoli says.

ISOLATION

For many Kenyans, the loss of a job means isolation from friends, disintegration of the family unit and a profound sense of worthlessness, which is especially difficult to bear in a society that values one for their material acquisitions and the jobs they hold; they frown upon those who have not made it.

A 2017 World Health Organization annual report ranks Kenya as sixth among African countries with the highest depression rates. It says 1.9 million people suffer from common mental conditions such as depression, substance abuse, stress and anxiety.

Prof Atwoli says it’s inevitable that we’re going to see a higher rate of substance-related problems because many people are coping with anxieties during this time with drugs and alcohol. There is also going to be an increase in anxiety disorders and depression because of disruption of care when hospitals cut down on other services to take care of Covid-19 and fear of people going to hospitals.

Prof Atwoli says while there are no statistics to show whether the rates are high or low in the general population, he’s collecting information from heath workers and a report will come out soon.

“After the acute phase when we’re dealing with the direct threat, the next big threat will be in the area of mental health. Countries must [therefore] be prepared to deal with the long-term mental consequences. The level of depression is really worrying. We have to plan for the long-term to prepare ourselves to deal with these problems” he says.

PETTY CRIME

The crisis is already manifesting in petty crime and mindless violence in homes, according to sources at the National Crime Research Centre (NCRC).

Mr Mutahi Kagwe, the Health ministry Cabinet Secretary, recently said during a Covid-19 status briefing that the rising cases, some of which have ended in suicide, are a great concern to the government.

When President Kenyatta read his speech as he reopened the economy last week, he expressed concern at the rising tensions in homes. Cases of gender-based violence have increased, mental health issues have worsened, and teenage pregnancies have escalated, he said. He turned to churches and mosques that he had closed down for help.

“I appeal to social institutions, including the religious institutions, to exercise civic responsibility to bring these unfortunate trends to an end. We must always remember that the family is a projection of the State. If the family is under attack, the State is under attack. If the family is weak, the country is weak,” the President said.

Unfortunately for the affected, people treat mental illness as a spiritual rather than a medical condition such that many victims end up unattended to.

The President directed the NCRC to look into soaring cases of gender-based violence, the worrying trend of disempowerment of the girl child and child rights violations.

The centre was further ordered to prepare an advisory to security agencies on remedial action within 30 days for immediate prosecution of violators.

The wave of mental health conditions comes against a system that cannot contain it. Kenya’s mental health infrastructure is marked by human resource shortages, poor infrastructure, inadequate supply of medicines and funding, and high levels of stigma that prevent many from seeking help.

The only national facility, Mathari National Teaching and Referral Hospital was built in 1910, and most of the infrastructure is 110 years old and dilapidated.

However, Prof Atwoli says we may yet have a tool to tackle the problem. Even before the Covid-19 outbreak, the President had formed a task force on mental health whose report: “Mental health and well-being: towards happiness and national prosperity”, came out last week. It proposed creation of a commission to track mental wellness and happiness.

The report called for increasing financing for mental health, restructuring Kenya’s mental healthcare system, including dismantling structures like Mathari, and building other facilities that would promote dignified care for people with mental illnesses.

PUBLIC HEALTH EMERGENCY

It also addressed handling stigma through information and programmes to change mental health perceptions, education and information in school, and declaring mental health a public health emergency so that specialised programmes to deal with it are in place.

“The report came out on Tuesday and it addresses all areas that need to be dealt with. If the recommendations are implemented, the impact of any catastrophe, including Covid-19, will be lessened,” Prof Atwoli said.

The fear is that if left unchecked is that we may be looking at full blown crisis of suicides, senseless murders, alcoholism and drug abuse like we have never witnessed before.