Bridging the gap between Traditional Mental Health Practice and Clinical Healthcare
In a remote secluded village, several mud-walled grass roofed structures oval in shape dot the compound of the famous ‘miti mbili’, that is the two trees house. Inside the house is a man dressed in a flowing robe from head to toe with huge sticks, his mouth utters unfamiliar litanies and he is surrounded by what appears to be maids. The patients are on their knees, some are chained enduring regular canning, kicking, jabs in the name of exorcising demons. There are numerous such practices in Western Kenya purporting to provide mental health services. The place is thronged by visitors from different places. According to a victim’s father in Homa Bay County in Kenya.
I have been bringing my daughter here for the past six months, she developed mental problems after graduating from Moi University and started her internship in one of the local Secondary schools in Migori. She was my last hope after I had retired from teaching five years ago. I don’t know of any mental health hospital, but I heard of the healer’s fame. Some of the activities might be painful but we must endure for the sake of my girl.
Due to stigma associated with mental health, Human Rights Watch, (2020) indicate that people seeking traditional treatment sometimes have to eat, sleep and go to the toilet in a very small space, are locked together with other people, are forced to take medicine or other things like herbs and are chained for long periods. This is a clear representation of violation of basic human rights in dispensation of and treatment of mental health illnesses by untrained practitioners. In Western Kenya, just like the rest of the world, 25.3% to 33.5% of disability years are mental cases (Funk M., 2016). In the region, a large number of mental health cases are regarded as curse or sorcery. This was confirmed in a 2013 study that found out that the locals often attribute mental health complication to sorcery or ancestral spirits that are displeased. (Mbwayo A, et al). With this faulty information majority opt for alternative treatments such as traditional healers, and ritualist prayers.
Statistics indicate that a population of approximately 44 million people is served by only with 54 psychiatrists and 418 trained psychiatric nurses. (National Academy of Sciences, 2016). This leaves marginalised communities such as Western Kenya at the mercy of untrained traditional health practitioners. (ibid 2016). Due to inadequacies of mental health workers in the region, volunteers are recruited to fill the gaps as community health workers (CHWs). Unfortunately, most of them have no formal mental health training. Without proper guiding principles, many unscrupulous opportunists have taken advantage of this booming business as evidenced by the radio programmes marketing their services.
Violation of Rights of Mental Health Patients; Challenges, Protocols and Guidelines
Common and most prevalent challenges of mental health in Kenya and western region are; untrained mental health professionals, few mental health facilities, and low prioritization for MNS disorders in budget allocations. The current budget allocation is 0.01% of the national health budget. (Action Plan, 2020). As a result of the covid-19 pandemic there has been an increased demand for psychological first aid, access to mental health care and psychosocial support (Jaguga ,2020). Lay healers are ready to provide the needed services and we need to acknowledge that traditional healers have a critical role to play in our communities.”
Despite the challenges, and the blatant human rights violation to victims of mental health, these practitioners are flexible, accessible, and affordable in western Kenya, (Burns J, et al. 2015) have it that almost 50% of the Africa’s population consult traditional and religious healers for mental illness treatment before accessing formal biomedical health care. Hence, traditional untrained mental health practitioners play crucial role in mental health treatments gap and there is need to train them and involve them to improve overall mental health care.
There are relevant mental health care policies such as Kenya Health Policy 2014−2030, and the Health Sector Strategic and Investment Plan. There is need for harmonisation, sharing and exchange of knowledge and skills. In this case, referrals could be done and roll out of best practices. It is in this regard that Blink International is happy to collaborate with other stakeholders to empower untrained mental health practitioners and contribute towards the progressive realisation of the Mental Health Policy and the recently released mental health policy action plan (2021 – 2025).
This article was written by Nickson Magak and edited by Devon Andrews