By Joseph Maina
The Ministry of Health (MOH) will improve access to mental health services leading to early identification and effective management of mental disorders, suicidal behavior, alcohol and other substance use disorders.
“Through UHC, the ministry shall improve access to mental health services, management of mental disorders and harmful use of alcohol and other substances,” a statement from the ministry reads in part. In addition to improved access to mental health services, MOH is training primary and community health workers to enable them identify mental health problems in communities.
According to the health ministry, the government has prioritised suicide prevention as a key strategic action in the Kenya Mental Health policy (2015- 2030) and intensified efforts to reduce risk factors associated with the health systems. Principal Secretary for Health, Eng. Peter Tum said this will be realised through formulation and implementation of mental health policies and strategies, improving access to health care services, equipping health workers with competencies to manage suicidal behaviour and raising awareness about mental health, substance use disorders and suicide.
Globally, 800,000 people die annually by suicide, the PS noted, adding that it is also the second leading cause of death in young people aged 15-29 years. In Kenya, the WHO data indicates that about 1,408 people commit suicide annually which translates to four deaths daily. “Its impact on families, friends, communities and nations is devastating,” notes the ministry. While marking this year’s World Suicide Prevention Day, the PS urged community members to take responsibility, look out for persons with suicidal behaviour, engage them, link them to treatment and follow-up care, fight stigma and support those bereaved by suicide.
“That is why this year’s theme Working Together to Prevent Suicide is most befitting as it calls for communities to play a critical role in suicide prevention,” the PS noted, in a statement read on his behalf by Senior Deputy Director of Medical Services, Dr. Patrick Amoth. But according to one city clinical psychologist, the figures of annual suicides committed in the country as quoted by the health ministry could be lower than the actual figures on the ground. “Suicide was taboo in most traditional African societies,” said Dr Geoffrey Wango, a Senior Lecturer in counselling psychology at the University of Nairobi.
“The figure (1408 deaths annually in Kenya) could be lower than the real number of deaths.” Speaking to Health Business, Dr Wango noted that due to the stigma associated with suicide, the cause of death might be reported as something else as families seek to save face. As people become more sophisticated, there is a tendency to mask suicide and attribute the death to other causes, he added.
“The problem is that death itself is like finitude. So we fear talking about it, even when it occurs from natural causes. It becomes worse when the death is occasioned by suicide.” According to Dr Wango, psychosocial issues have been largely side-lined in many developing countries as opposed to the developed world. He said social and economic pressures of the day might be a key factor in the high number of suicides reported. “We had support systems in most traditional communities,” he said.
“Today, however, individualism has taken root.” Society should be on the lookout for possible signs of suicidal behaviour, he added, such as isolation and withdrawal. He termed alcohol and substance abuse as secondary symptoms. “We need people to understand depression,” he said, while observing that society has wrongly labelled victims of depression as mad people. “People are increasingly stressed, due to economic and other reasons. We need to address the issue in our schools, homes and communities.”
Dr Wango stated that a person who commits suicide might actually do it unconsciously. “Does the person really want to commit suicide?” he posed. “Suicidal tendencies are sometimes a cry for help. Suicide is complex. It is not easy to tell between the person who actually wants to die from one who is crying for attention.” He cites the ages of 15-35 and persons over 65 as two groups that are particularly predisposed to suicide, and identifies depression as among the top ten causes of suicide in the country within the next 10 years.