African Woman and Child Feature Service - Kenyans embrace the mentally ill, but…. Written by Arthur Okwemba Monday, 03 May 2010 11:18
When Prof David Ndetei rewinds his memory to 20 years ago on how mental illness was handled, he can afford a smile. At that time, stigma was at its peak and mistreatment of the mentally ill and disabled persons was the order of the day.
Forward to present, the situation is much different. Psychiatrists like him say society is finally beginning to understand that mental illness is treatable or manageable and those affected can be productive members of the society.
He remembers in the 1980’s and early 1990’s of how the mentally ill would consult him only at night to avoid being seen. “Now they walk into my clinic or other institutions catering for the mentally ill in broad daylight.”
Dr Nelly Kitazi, Superintendant of Mathari Hospital, thinks people are increasingly seeing mental illnesses as a brain disorder and not a personal failing, thanks to aggressive awareness by advocates who include professionals, politicians, church leaders and government officials.
In recent times, there has been aggressive advocacy to fight stigma related to mental illness with great success. According to Prof Ndetei, the way people handle the mentally ill now is a great improvement of what happened two decades ago.
“There is much acceptance and willingness to help them as people understand the disease better. This understanding is playing a major role in reducing stigma.”
Pattni Prabhudas, the Secretary General of Kenya Association of the Mentally Handicapped (KSMH) is upbeat the mentally disabled persons are getting better treatment than was the case 10 years ago.
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African Woman and Child Feature Service - Kenyans embrace the mentally ill, but…. Written by Arthur Okwemba Monday, 03 May 2010 11:18
“Unlike in the past when people hid from the public their mentally disabled, now we see many of them coming to us in to seek help for their children or family members.”
In one of our past awareness activities, more than 800 people responded to the Association’s call to families to come and register their mentally disabled persons in the mapping exercise. This happened in a span of one month.
“This impressive response does not only indicate that stigma is reducing, but will also help us have rough idea of how many mentally disabled people are out there,” says Prabhudas.
KSMH has enlisted the support of influential people in the religious, political and economic circles to help fight the stigma against the condition.
But the country is not out of the woods yet. Prof Ndetei and Dr Nelly Kitazi say lack of understanding and misconceptions about mental illness is still fuelling stigma in many parts of Kenya.
The main reasons why people stigmatise the mentally ill is because they link the disease to madness or lunacy, a curse or demonic possession, says Dr Kitazi. People with a mental disorder are viewed as dangerious, aggressive, and uncoordinated.
Media and movies portrayal of the mentally ill in their language and images is said to reinforce and sustain this stigma as well.
It is this stigma that is the root cause of mistreatment, social exclusion, and poor management of people with mental disorders and disability. Although not rampant now, families still chain or hide from the public their mentally retarded patients, practices that were banned in the 19th century.
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African Woman and Child Feature Service - Kenyans embrace the mentally ill, but…. Written by Arthur Okwemba Monday, 03 May 2010 11:18
Families who are unable to live with mentally ill and who harbour intense stigma abandon them in hospitals such as Mathari. There are numerous complains at the hospital by patients who say they are rarely visited by family members. A female patient who lamented of feeling lonely and stressed asked me if it was possible to visit her at least once a month.
Cases of abandonment by family members are prevalent at hospital, making it very difficult for the facility to sustain these patients.
“Many families would prefer their patients to stay here for the rest of their lives, and never bother to come and visit them,” says Dr Kitazi.
At the moment, there are two patients who have been at the hospital for more than 25 years and no family member has paid them a visit. Their medical bills are however paid promptly by the same family members through the hospital’s account.
“Abandonment of patients is rife, especially with families who stay out of Nairobi. Once they bring a patient here, they might not come back to check on him or her. Interestingly, they will continue paying the bills,” explains Botela Keziah, a matron at the hospital.
There cases where patients have been brought to the hospital by family members even after
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African Woman and Child Feature Service - Kenyans embrace the mentally ill, but‌. Written by Arthur Okwemba Monday, 03 May 2010 11:18
being discharged.
“When the patient comes back, they tell us their people say they are not ready to accept them back within the family setting,� says Keziah.
This has left the hospital nurses and staff to offer the patients the love and care which they are not getting from family members.
Mistreatment of this nature has made some patients to prefer staying at the hospital where they are appreciated away from their hostile relatives.
Some of the nurses at the hospital say if the medical person or family member harbour stigma, then it becomes very difficult to handle and help their patients who include doctors, lawyers, teachers and other professions, recover.
The other consequence is the person with mental disorder or disability they are denied access
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African Woman and Child Feature Service - Kenyans embrace the mentally ill, but…. Written by Arthur Okwemba Monday, 03 May 2010 11:18
to jobs, loans, property ownership, and other essential of life just because people equate their mental disorder to madness. Their families fail to seek treatment as they feel shame to move with them in public.
Those affected usually start stigmatizing themselves when they see people rejecting or excluding them. Even their struggle to seek medical attention or to get well is compromised, doctors moan.
“Only what you need to do is to let the patient win your trust, and know what the repercussions are if they wrong,” says Keziah.
“If a patient who is a teacher by profession seems to want certain kind of respect befitting his profession, we respond accordingly. This helps to avoid aggravating his or her condition or enhance the already existing stigma.”
In addition to the family, other perpetrators of stigma are health practitioners in institutions catering for those with mental disorders, communities, and the mentally ill themselves.
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African Woman and Child Feature Service - Kenyans embrace the mentally ill, but‌. Written by Arthur Okwemba Monday, 03 May 2010 11:18
Many of these people rarely take time to understand why the mentally ill behave the way they do; rarely show them love; or acceptance. They believe those who are mentally ill have either brought it upon themselves by committing serious sins or engaging in immoral behaviours.
Others think certain families are destined to have mentally ill persons. For such families, no one is willing to marry their daughter or son. They are avoided by the community in social functions. All these practices, says Dr Kitazi, enhance stigma and mistreatment of those with mental disorder.
Advocates of the rights of the mentally ill have accused the government for doing little to improve facilities and services within institutions catering for the mentally ill. Current allocations to mental health care is about less than 0.1 percent against a budget that runs into hundreds of millions. All this, they say, is an indication of intense stigma among government officers.
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