Updated: May 27, 2020
Kenya faces an unprecedented mental health and wellbeing challenge in the age of coronavirus
By Rand Pearson
As Kenya and still much of the world endures another quarter of lock down measures, many Kenyans face a bleak future of more isolation, creating an environment ripe for anxiety, depression and loneliness, with the worst-case outcome being a possible rise in suicides.
A recent report published by JAMA Psychiatry points to a perfect storm brewing between suicide mortality rates and Covid 19. "Remarkable social distancing interventions have been implemented to fundamentally reduce human contact, [but] the potential for adverse outcomes on suicide risk is high, which also represents a national public health priority," the report states.
Is the Kenya Government listening?
There is a pile of compelling, anecdotal evidence showing that Kenyans are getting highly stressed out. Two Nairobi-based online mental health startups are seeing a sharp and sudden increase in vulnerabilities among their client base, brought on by general panic around the coronavirus pandemic—factors that include economic stress, isolation and barriers to mental health treatment.
Bright Shitemi heads the mental health advocacy group, Mental 360, which also operates a free online outreach and referral app. “We are seeing a lot of suicide ideation, even with people who are experiencing panic attacks and depression. Unfortunately we don't get data on people who have actually gone and done the act. But many of the people reaching out are saying, ‘yeah, I've had suicidal ideations; I've thought a lot about it’,” says Shitemi.
Shitemi says Mental360 is witnessing a three-fold increase in app usage and call-ins during the past two months from people already living with mental health conditions experiencing breakdown episodes. Many others are experiencing mild to severe panic attacks do to a deteriorating economic situation and the prospect of losing their jobs or businesses. He is also witnessing a stark increase in calls related to gender-based violence, domestic violence and substance abuse.
“Calls around issues of general anxiety have gone up by 150 percent [since the onset of coronavirus], and about 60 percent of the total calls we are getting in are related to people experiencing panic attacks. So this is a huge increase for us,” says Shitemi. “Most of the other issues are related to depression and substance abuse.”
Inuka is another digital mental health organisation and application offering one-on-one online chats with certified wellness experts. It has witnessed a doubling of the use of its services during Coronavirus, with a special focus on employers looking to cope with remote working conditions and the wellbeing of their employees.
Anikza Gakunu paints a new harsh reality for young professionals.
Even before coronavirus, Inuka conducted a report stating that on average 30 percent of the work force in Nairobi is experiencing burnout and chronic stress due to long hours. Based on what her clients' HR departments are telling her, “we’re going to see that number double,” says Gakunu.
Underscoring this, Gakunu tells the story of Mwangi (not his real name). He is a married father in his mid 30s. He is used to being on the go day and night, socialising and doing business as a facilitator or some sort of connector, hustling the Nairobi way. Because of remote working he’s locked at home facing a relationship and a marriage he has previously ignored, and getting stuck in a situation where he's not able to provide for his family. He's frustrated. He starts drinking heavily, withdraws from his family and starts to experience an existential crisis—facing down a life that just crumbled away and a family looking to him for relief. Similar situations across Kenya are leading to depression and domestic abuse on both sides of the gender coin.
Many women, who are the household money winners, are suffering from anxiety about their economic future, and they represent the vast majority of people calling online mental health services such as Mental 360 and Inuka.
“Seventy percent of our users are female, and thirty percent are male,” says Inuka. “Normally it's quite clear cut: the females tend to be addressing relationship issues and frustrations of uncertainty and feeling stifled, and obviously their financial situation.”
While women are more open to speaking about their problems and seeking help, men tend to hold everything inside because of the stigma about speaking out on mental health issues. It’s just not done in Kenyan society.
“This is why men are committing suicide on the ratio of 5-to-1 as compared to women,” says Shitemi. “The African man cannot show weakness in our culture.
“In this country we haven't taken mental health seriously because of stigma. People -- even people in high office – are going through these challenges but they will never speak about it; so then that means even the people who are making policy can't talk about mental health,” says Shitemi.
Watch the full UP Africa interview with Bright Shitemi
The state of mental health at the national level is dire. Mathari Hospital, Kenya’s largest mental health referral and training institute is rundown, neglected and without the resources to cope with the country’s increasing demand for mental health services during coronavirus.
Senator Sylvia Kasanga, with a coalition of private and public partners, is on the front lines of fighting for and advocating mental health policy within the government. She has been bombarded by several ‘horror stories’ of people suffering from mental illnesses not being able to access medication and in-patient services during lockdowns.
Kasanga reports in one case that a man suffering from violent episodes travelled from North Eastern on his own to seek help and treatment at Mathari and was turned away at the door because the hospital, six weeks into lockdown measures, still did not have the masks, gowns and gloves to protect doctors and nurses against coronavirus.
Senator Kasanga is sponsoring a rewrite of a mental health bill that has been circulated since 1989, a sure sign that for as many years Kenya has not taken the mental health of its citizens seriously. Revised and re-drafted by Kasanga in 2018, the new updated bill seeks to fully integrate mental health into the national healthcare system. The arguments and advocacy for this campaign are summarised in the 2018/19 report, “The Many Faces of Mental Health in Kenya,” conceptualised by Kasanga and sponsored by Open Society Foundation.
“We are asking the government to have a stand alone budget for mental health,” says Kasanga. “To date, there is no stand alone budget allocated for mental health, and now with Covid, our underbelly is really showing.”
Even with a lack of resources at the national level many organisations like Inuka and Mental 360 are helping to fill part of this enormous gap. Creative Director Jason Bruckner started @Headspace254 on the back of personal experiences with addiction and suicide to give support to those working in the creative industries and to bring mental illness out of dark corners.
Bruckner was also a creative force behind the “Many Faces” publication and the campaign: “It’s Okay, to Not Be Okay.”
“We’re trying to make mental health cool, and change the way people talk about it,” says Bruckner. “It doesn’t have to be serious; we can normalise it as a subject.
“There is so much shame around it and stigma, because when we think about mental illness, it’s the crazy guy walking down the street in trash bags, screaming. But it can also be everyday issues, like getting stressed out in a matatu on the way to work.”
Everyday stress and burnout in the office, especially now with coronavirus, is a precursor to depression and anxiety.
Online services and social media groups are free and accessible ways to air out issues with peers. The important thing, according to Shitemi, is to share and reach out to others as the number one way in fighting even mild forms of anxiety and depression.
“I also encourage people to one, stay away from negative news. Negative news will only serve to heighten your panic or your anxiety,” says Shitemi. “Two, stay positive, stay engaged, eat healthily, if you can. If you can't, (do any of this) reach out to us (or the many other services out there); stay positive, we know it's a difficult time, but we can get through this together.”
In addition to online services, there is an increasing movement towards alternative therapies—from psychotropics to energy medicine.
Sapna Chandaria is an energy therapist and owner of Soulful Living, based in Nairobi. She is regularly counselling her clients through a process of letting go of limiting belief systems that cling to us through life.
"If you can accept the idea that we hold onto mental programming that keeps us locked in a limiting view of our self, like the state of being a victim, for example, then you are also open to the idea that you can be un-programmed—that opens the possibility of healing the root cause, which may lead to mental illness or instability, says Chandaria.
"I see many people where the root cause of the issues they are experiencing, comes from a place of lost love for self—a sense of complete unworthiness. My work is to remove these negative beliefs from each part of their energy system, which then provides a permanent shift because the healing is affecting the entire holistic system of the person."
Be it counselling, alternative treatments or simply reaching out to a friend, the good news is that there is help out there, if you know where to look. And while many Kenyans await a concerted government response to mental health, for now they will have to take matters into our own hands.