Increasing uptake of mental health services by communities in Magarini

By Dennis Musyoki

Cosmus Mzungu (standing), a clinical officer from Gongoni Health Center talking about mental health during a community forum held at Gongoni Chief’s office on 22nd July 2022. Photo by Dennis Musyoki

It’s a bright sunny morning at the Gongoni Chief’s office, located in the expansive Magarini Sub County in Kilifi County. Residents trickle in, some walking alone, some walking in pairs, while others walking in groups of three.

You can hear them speaking in hushed tones as they walk in, and their conversations are a mix of Giriama which is the most popular local dialect, and Swahili, which is the national language and also widely spoken in this area.

These residents have turned up for today’s community forum.

The community forum, which is being led by the Mental Health team at Gongoni Health Center, has been organised for the purpose of initiating discussions around “Afya ya Akili,” Swahili for mental health.

In attendance are area residents, members of the administrative units represented here by the area Chief and Nyumba Kumi (a national government strategy of anchoring Community Policing at the household level) members, Mental Health Champions, religious leaders, and healthcare workers.

From these initial discussions and by their own admission, it’s apparent that many of these community members know so little about mental health. Most of the men in this forum for instance, reveal that they prefer not to speak up on issues bothering them. They contend that it’s un-African for men to show weakness or emotions.

This notion is however quickly debunked by the healthcare workers who highlight the fact that failure to adequately address seemingly small problems, tends to lead to bigger problems which end up resulting in depression as a result of piling up of these unresolved problems. It’s therefore important for men to overcome the stigma associated with seeking for help and embrace positive health seeking behavior.

When the topic of depression comes up, the discussion seems to dwell a lot on the challenge of family feuds, as community members are of the opinion that wrangles within families, that tend to be hard to solve, are a huge contributor to mental health conditions such as depression. It thus doesn’t come as a surprise when these community members opine that most mental health conditions stem from the family unit.

To this discussion, the healthcare workers bring up the subject of counselling. The community is informed about counselling services at the facility and encouraged to seek for these services in case they encounter family feuds that are hard to solve. Couples are also encouraged to normalize counselling as unresolved family issues tend to grow and negatively affect the kids as well.

Josephine Muheto (standing), a Community Health Extension Worker (CHEW) talking about mental health during a community forum at Marereni Chief’s office on 25th July 2022. Photo by Christine Mwaringa

The group further learns that through more mental health awareness, early detection and preventive measures, mentally ill persons can be able to overcome stigma and accept themselves and the condition that they have, provided they have better support from their family and community.

The community therefore resolves to use the structures at their disposal to create more awareness around mental health with the goal of improving treatment seeking behavior. Some of the suggestions that are brought forward are, the use of the nyumba kumi members to create awareness on mental health in their respective localities and refer anyone who may potentially be having a mental health condition to professional help.

The area chief also commits to supporting this initiative by looking for ways to link the residents with a mental health expert for medical attention.

The Nyumba Kumi members through the area Chief also make a recommendation to have a full-fledged outpatient mental health unit at Gongoni Health Centre. They would like this unit to be able to provide consultation, counselling, and treatment services. They believe this is going to save the community the hassle and cost of having to go all the way to Malindi which is about 30km away or Mombasa which is about 150km away, to seek for treatment.

They are confident that this is going to reduce stigma, as many community members would be willing to turn out at the clinic for treatment. In addition to this, having these services closer to the community, will make those with mental health conditions feel as part of the community and not as rejects.

This will moreover promote togetherness of the wider community as they will be out to support one another and provide solutions to the common problems they face, hence reducing victimization and stigmatization of mentally ill persons. Instead, they will get the much-needed support.

As today’s forum concludes, the area residents and the other attendees, have one resolve, “Tumalize unyanyapaa dhidi ya watu wenye magonjwa ya kiakili.” Swahili to mean, “Let’s end stigma against persons with mental health conditions.”

This community forum was organised as part of the Inclusive Communities project, which is a collaboration by Basic Needs Basic Rights Kenya, CBM Global Disability Inclusion, and the County Government of Kilifi, with funding from Irish Aid.

Story compiled by Dennis Musyoki, a healthcare worker and community member residing in Kilifi County, as part of an initiative by the Inclusive Communities Program to give community members an opportunity to self-document the program’s progress and impact.

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