Effective Governance Approaches in the Management of Mental Health within the Public Sector of Kenya; A Literature Review

Main Article Content

Susan Kiilu https://orcid.org/0009-0008-1116-0639
Hinneh K. Mandela https://orcid.org/0000-0002-7418-0820
Paulah M. Ngei
Kipkogei Chemitei https://orcid.org/0000-0002-5358-6573

Keywords

Mental health, issues, leadership, governance, Kenya

Abstract

Highly widespread, mental disorders is a significant contributor to the global burden of disease, presenting a growing challenge to the worldwide healthcare system. The increasing prevalence of mental health disorders in Kenya is a growing concern, affecting at least 25% of the population and rising rapidly. The impact of mental health illness in Kenya is profound as such, the strategies employed in their management must be comprehensive, culturally sensitive, and tailored to the unique needs of the Kenyan population. Kenya public sector plays a pivotal role in healthcare delivery. This study therefore assessed governance approaches in the management of mental health within the public sector of Kenya. This review aims to inform policymakers, practitioners, and researchers on the most effective strategies to promote mental health initiatives within the public sector of Kenya, ultimately contributing to the enhancement of mental health outcomes for the population. Scopus, Web of Science, and Google Scholar were employed to extensively search for scientific articles, technical papers, and government documents regarding the prevalence and governance approaches in managing mental health. Kenya is experiencing a rapid increase in depression, suicide, substance use disorder, bipolar disorder, schizophrenia, anxiety, obsessive-compulsive disorder (OCD), phobias, eating disorders, attention deficit hyperactivity disorder, and dementia, an indication of social challenges and unmet needs at societal level. The most recent guideline for implementing mental health system reforms in Kenya is outlined in the Kenya Mental Health Policy 2015-2030. This policy focuses on enhancing effective leadership and governance to address mental health challenges in the country. Despite advancements made, there are lingering challenges such as a scarcity of mental health professionals, insufficient medication, inadequate facilities, financial constraints, and governance issues. There is a need to strengthen mental health governance with an objective of improving oversight and National and County coordination on mental health. Also, there need for National Government to increase budget allocation to mental health services within the public sector to ensure adequate funds for program implementation.

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References

African Population and Health Research Center (APHRC), University of Queensland, and Johns Hopkins Bloomberg School of Public Health. (2022). Kenya – National Adolescent Mental Health Survey (K-NAMHS): A Report on Key Findings. Nairobi, Kenya: APHRC

Ali, N. A., Owiti, F., Kigamwa, P., & Kumar, M. (2019). A Qualitative Exploration of Gaps and Challenges in Knowledge and Practices of Electroconvulsive Therapy by Key Personnel in Public and Private Mental Health Units in Kenya. Frontiers in Psychiatry, 10, 697.

Angachi, M. O. (2014). The psychosocial aspects among adult cancer patients attending oncology clinic at Moi teaching and referral hospital, Eldoret, Kenya (Doctoral dissertation, University of Nairobi).

Arihta, C., Fujiono, D., Moniaga, J. V., & Rianto, I. D. (2022, October). A Review of Gamification Related to Mental Health Treatment. In 2022 3rd International Conference on Electrical Engineering and Informatics (ICon EEI) (pp. 172-176). IEEE.

Auditor General (2017). Performance Audit report on provision of mental health care services in Kenya

Bickenbach, J. (2015). WHO’s definition of health: philosophical analysis. Handbook of the Philosophy of Medicine, 1.

Bitta, M. A., Kariuki, S. M., Gona, J., Abubakar, A., & Newton, C. R. (2019). Priority mental, neurological and substance use disorders in rural Kenya: traditional health practitioners’ and primary health care workers’ perspectives. PloS one, 14(7), e0220034.

Bunyassi-Asuga, L. M. (2008). Prevalence of substance abuse among forensic psychiatry inpatients at Mathari Hospital Nairobi, Kenya (Doctoral dissertation, University of Nairobi).

Egbe, C. O., Brooke-Sumner, C., Kathree, T., Selohilwe, O., Thornicroft, G., & Petersen, I. (2014). Psychiatric stigma and discrimination in South Africa: perspectives from key stakeholders. BMC psychiatry, 14, 1-14.

Getanda, E. M., Vostanis, P., & O'Reilly, M. (2017). Exploring the challenges of meeting child mental health needs through community engagement in Kenya. Child and Adolescent Mental Health, 22(4), 201-208.

Harper, G. W., Crawford, J., Lewis, K., Mwochi, C. R., Johnson, G., Okoth, C., ... & Wilson, B. D. (2021). Mental health challenges and needs among sexual and gender minority people in Western Kenya. International journal of environmental research and public health, 18(3), 1311.

Hinga J. (2023). Mainstreaming Mental Health in Kenya. Strathmore university.https://sbs.strathmore.edu/mainstreaming-mental-health-in-kenya/

Hossain, M., Pearson, R. J., McAlpine, A., Bacchus, L. J., Spangaro, J., Muthuri, S., ... & Izugbara, C. (2021). Gender-based violence and its association with mental health among Somali women in a Kenyan refugee camp: a latent class analysis. J Epidemiol Community Health, 75(4), 327-334.

Javed, A., Lee, C., Zakaria, H., Buenaventura, R. D., Cetkovich-Bakmas, M., Duailibi, K., ... & Azeem, M. W. (2021). Reducing the stigma of mental health disorders with a focus on low-and middle-income countries. Asian journal of psychiatry, 58, 102601.

Jenkins, R., Othieno, C., Omollo, R., Ongeri, L., Sifuna, P., Mboroki, J. K., ... & Ogutu, B. (2015). Probable post traumatic stress disorder in Kenya and its associated risk factors: a cross-sectional household survey. International journal of environmental research and public health, 12(10), 13494-13509.

Kabugi, F. (2019). Opportunities for faith based organizations in substance use prevention: a Christian perspectives. Educational Review: International Journal, 16(1).

Kenya Mental Health Action. Plan 2021–2025 [Internet]. The Taskforce on Mental Health. [cited 2021 Sep 18]. Available from: https://mental.health.go.ke/download/kenya-mental-health-action-plan-2021-2025/.

Kenya Mental Health Policy.pdf [Internet]. [cited 2021 Jun 30]. Available from: https://publications.universalhealth2030.org/uploads/Kenya-Mental-Health-Policy.pdf.

Kiilu, C., Musembi, J., Mukami, D., Mwenda, C., Opanga, Y., & Kimathi, G. (2022). Disparities in Knowledge, Attitude and Practices on Mental Health among Healthcare Workers and Community members in Meru County, Kenya. medRxiv, 2022-03.

Kithinji, C. M. (2013). Mental health issues of women living with HIV/AIDS: HIV-seropositive women's experiences in Kenya (Doctoral dissertation, The University of Wisconsin-Madison).

Kučukalić, S., & Kučukalić, A. (2017). Stigma and suicide. Psychiatria Danubina, 29(suppl. 5), 895-899.

Kwobah, E. K., Turissini, M., Barasa, J., Kimaiyo, M., Okeyo, L., Araka, J., ... & Jaguga, F. (2023). Mental healthcare services in Kenyan counties: a descriptive survey of four counties in Western Kenya. BMC Health Services Research, 23(1), 1-7.

Kwobah, E., Jaguga, F., Robert, K., Ndolo, E., & Kariuki, J. (2021). Efforts and Challenges to Ensure Continuity of Mental Healthcare Service Delivery in a Low Resource Settings During COVID-19 Pandemic—A Case of a Kenyan Referral Hospital. Frontiers in Psychiatry, 11, 588216.

Larsen, L. T. (2022). Not merely the absence of disease: A genealogy of the WHO’s positive health definition. History of the Human Sciences, 35(1), 111-131.

Lutta, P. (2016). Corruption and Enforcement Personnel as Factors that Influence the Implementation of Alcohol and Drug Abuse Policies in Nairobi County (Doctoral dissertation, University of Nairobi).

Marangu, E. (2018). Mental health care in Kenya: investigating strategies for capacity building in primary health care settings (Doctoral dissertation, Deakin University).

Marangu, E., Mansouri, F., Sands, N., Ndetei, D., Muriithi, P., Wynter, K., & Rawson, H. (2021). Assessing mental health literacy of primary health care workers in Kenya: a cross-sectional survey. International journal of mental health systems, 15, 1-10.

Mbuthia, J. W., Kumar, M., Falkenström, F., Kuria, M. W., & Othieno, C. J. (2018). Attributions and private theories of mental illness among young adults seeking psychiatric treatment in Nairobi: an interpretive phenomenological analysis. Child and adolescent psychiatry and mental health, 12(1), 1-15.

Media Council of Kenya (2021). State Of Mental Health. https://mediacouncil.or.ke/sites/default/files/downloads/Mental%20Health%20Report.pdf

Memiah, P., Wagner, F. A., Kimathi, R., Anyango, N. I., Kiogora, S., Waruinge, S., ... & Otiso, L. (2022). Voices from the youth in Kenya addressing mental health gaps and recommendations. International Journal of Environmental Research and Public Health, 19(9), 5366.

Menzies, P. (2010). Intergenerational trauma from a mental health perspective.

Meyer, A. C., & Ndetei, D. (2016, February). Providing sustainable mental health care in Kenya: a demonstration project. In Providing Sustainable Mental and Neurological Health Care in Ghana and Kenya: Workshop Summary. National Academies Press (US).

Mfoafo-M’Carthy, M., & Huls, S. (2014). Human rights violations and mental illness: implications for engagement and adherence. Sage Open, 4(1), 2158244014526209.

Ministry of Health (2015). Kenya Mental Health Policy 2015–2030. https://repository.kippra.or.ke/bitstream/handle/123456789/601/Kenya-Mental-Health-Policy.pdf?sequence=1&isAllowed=y

Ministry of Health (2021). Kenya Mental Health Action Plan 2021 – 2025. https://www.aku.edu/bmi/Documents/kenya_mental_health_action_plan__2021-2025_.pdf

Ministry of Health, Mental Health Taskforce urges government to declare mental health a National Emergency Nairobi, 7 July 2020, 1.

Murunga F, (2019). ‘World Mental Health Day: Suicide in Kenya’ African Population and Health Research Centre, 10 October 2019-< https://aphrc.org/blogarticle/world-mental-health-day-suicide-in-kenya/.

Musyimi, C. W., Mutiso, V. N., Musau, A. M., Matoke, L. K., & Ndetei, D. M. (2017). Prevalence and determinants of depression among patients under the care of traditional health practitioners in a Kenyan setting: policy implications. Transcultural psychiatry, 54(3), 285-303.

Mutiso, V. N., Musyimi, C. W., Gitonga, I., Tele, A., Pervez, R., Rebello, T. J., ... & Ndetei, D. M. (2020). Using the WHO-AIMS to inform development of mental health systems: the case study of Makueni County, Kenya. BMC Health Services Research, 20, 1-12.

Ogourtsova, T. (2023). Telerehabilitation for the Mental Health of Children with Physical Disabilities and Their Families: Let’s Look out the Window of Opportunity!. Physical & Occupational Therapy In Pediatrics, 43(2), 176-181.

Olwanda, E. (2021). Exploring barriers to the utilization of mental health services at public and private healthcare facilities in Vihiga sub-county, western Kenya: a case study of healthcare providers (Do

Osborn, T. L., Venturo-Conerly, K. E., Wasil, A. R., Schleider, J. L., & Weisz, J. R. (2020). Depression and anxiety symptoms, social support, and demographic factors among Kenyan high school students. Journal of Child and Family Studies, 29, 1432-1443.

Paul, S., & Dasgupta, C. (2022). Stigma, Discrimination, and Human Rights Violations of People Living with Mental Illness in India. In Handbook of Social Inclusion: Research and Practices in Health and Social Sciences (pp. 989-1004). Cham: Springer International Publishing.

Pavanello, S., Elhawary, S., & Pantuliano, S. (2010). Hidden and exposed: Urban refugees in Nairobi, Kenya (p. 23). London: Overseas Development Institute.

Roberts, S. T., Flaherty, B. P., Deya, R., Masese, L., Ngina, J., McClelland, R. S., ... & Graham, S. M. (2018). Patterns of gender-based violence and associations with mental health and HIV risk behavior among female sex workers in Mombasa, Kenya: a latent class analysis. AIDS and Behavior, 22, 3273-3286.

The Borgen Project (2020). Mind Over Matter: Mental Health in Kenya. https://borgenproject.org/mental-health-in-kenya/

Tsofa, B., Goodman, C., Gilson, L., & Molyneux, S. (2017). Devolution and its effects on health workforce and commodities management–early implementation experiences in Kilifi County, Kenya. International journal for equity in health, 16(1), 1-13.

WHO (2022). Mental health. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response

WHO (2017). Depression and Other Common Mental Disorders: Global Health Estimates. 2017. Available online: http://apps.who.int/iris/bitstream/10665/254610/1/WHO-MSD-MER-2017.2-eng.pdf?ua=1&ua=1

Willner, P., Rose, J., Stenfert Kroese, B., Murphy, G. H., Langdon, P. E., Clifford, C., ... & Cooper, V. (2020). Effect of the COVID‐19 pandemic on the mental health of carers of people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 33(6), 1523-1533.

World Health Organization. (2015). The European mental health action plan 2013–2020.

World Health Organization. (2016). mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: mental health Gap Action Programme (mhGAP). World Health Organization.

World Health Organization. (2019). The WHO special initiative for mental health (2019-2023): universal health coverage for mental health (No. WHO/MSD/19.1). World Health Organization.

Wren-Lewis, S., & Alexandrova, A. (2021). Mental health without well-being. In The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine (Vol. 46, No. 6, pp. 684-703). US: Oxford University Press.