By Phyllis Luhale

I have been working at Kimilili Sub County Hospital as a Psychiatric Nurse for three years. In the period I have been here, I have noted that mental health conditions are very rampant in this county. In this facility alone, we deal with many cases of depression, substance use disorders, schizophrenia and bi-polar disorder, just to mention a few. In a month I see about 80 patients, with the common illness noted being schizophrenia.

Why we provide outreach services

Outreach services are very important in this county because we have noted that the levels of mental health literacy are very low. There are very many community members with mental health conditions and their caregivers are not aware that mental health services are available at health facilities such as Kimilili Sub County where I work.

In addition to this, the average distances from this facility to most homesteads are quite far with people having to travel up to between 30 and 50 kilometres which is not only expensive in terms of logistics but also in terms of cost of treatment because services are not free at this health facility.

Through outreaches, we take services closer to the community, and this is primarily done at health centres and dispensaries in the community which are not only closer, with patients and caregivers travelling for at most, 5 kilometres, but services are also free of charge. This means a significant reduction in logistics as well as treatment costs.

Prior to the BNBR intervention, we rarely provided outreach services due to lack of funds. However, with support from this project, we are able to conduct outreaches on a monthly basis where I personally attend to around 25 clients per day during an outreach.

We are enhancing mental health literacy

From my observation, many of the mental health conditions in this area are either genetic or the result of negligence. The most challenging to address are the ones that result from genetics because of the huge misconception that they are the result of curses. For instance, if a grandfather, his son and then grandson have schizophrenia, the general belief is that this family is suffering from a generational curse. They will often seek services of a witch doctor or sorcerer.

We therefore engage in a lot of awareness creation in the community ensuring that we emphasize on the need for treatment, as mental illnesses are just like any other illnesses which can be treated or managed especially if this starts early.

We are noting an increase in uptake of services particularly once community members see positive change in other members being attended to during our monthly outreach clinics.

Caregivers are also changing their mindsets. One particular case that comes to mind is that of my client who has bipolar. Her parents had neglected her assuming she would not amount to anything. They had branded her as sick and stubborn. However today, following treatment and management of the illness, she is now in a good state. Her parents have even become positive and have enrolled her for a course in a local college.

Plenty of work is still needed

Whereas we have been able to achieve plenty, there are still challenges that we face. The increase in demand for services has resulted in more demand for psychotropic medication. However, we are experiencing frequent stockouts resulting in our clients frequently missing their much-needed medication. This negatively impacts their recovery process. It would be really helpful if we got more support to purchase psychotropic medication to keep up with growing demand.

We also need to do more outreach activities as this is a vast and highly populous county, and we therefore need to broaden our reach to other communities that really need these services.

We have seen the benefits in the areas where we are already intervening, and I strongly feel that these benefits should be extended to other areas where there is also need.

All in all, my colleagues and I are appreciative of this initiative, and we look forward to positively transforming more lives in our communities through enhancing their mental health and wellness.