•Chege says introducing other services will be easier for mental patients to visit the facility without the fear of being judged
•The level six referral hospital lacks adequate staff and is grossly underfunded
The government plans to expand Mathari National Teaching and Referral Hospital to offer other services besides mental healthcare.
The proposal by Murang'a Woman Rep Sabina Chege is aimed to the negative perception of the facility and make it easier to fight the growing burden of mental illness.
The National Assembly Health committee chairperson wants the facility run as an autonomous entity.
“If we introduced other services it will be easier for someone going through a mental health issue to walk into the facility without the fear of being judged. They can, for instance, say they are going to have a simple dental checkup,” Chege said.
Founded in 1910 the hospital which neighbours the sprawling Mathare slum has 675 patients in its general wards.
Mathari Hospital does not have adequate qualified personnel to handle the number of patients seeking mental healthcare.
The situation has been compounded by the shortage of psychiatrists countrywide. The country needs 1,533 psychiatrists.
Of the 17 psychiatrists and 179 psychiatric nurses in public hospitals in Kenya, seven psychiatrists and 104 psychiatric nurses are deployed at Mathari.
In addition, the hospital deals with some patients who have violent tendencies and may pose a big risk to fellow patients and staff, which makes it hard to attract qualified personnel.
The level six referral hospital is expected to provide the highest degree of specialised care, but understaffing and underfunding have left the facility in a wretched state, dealing a blow to mental healthcare in the country.
“We have to change the approach. When we visited the facility sometime back we found one nurse caring for almost 150 patients while some of the patients had been at the facility for almost 20 years,” Chege said.
The long stay at the facility has been attributed to drugs shortage due to low funding. Sometimes the hospital experiences stockouts for even a month.
This has brought about more psychological anguish to patients, leading to higher operational costs.
The World Health Organisation recommends a ratio of one psychiatric nurse to six mentally ill patients.
An report released by the office of the Auditor General last year attributed the inadequate personnel to the hospital's inability to retain staff as compared to the private institutions that provide better pay and working conditions.
An insider at the facility who spoke to the Star on condition of anonymity painted a grim picture of the facility, from congestion to shortage of staff and medicines and key equipment.
The report by the auditor which examined operations at the facility for five financial years covering 2011-12 to 2015-16 found that although it was grossly underfunded, Mathare could not fully account for part of the money it received.
According to the report, the hospital collects about Sh76.5 million every year for improvement.
In 2015-16 the facility collected Sh91.7 million through a cost-sharing mechanism with patients.
“We need to relook financing in terms of how much NHIF is covering in metal health and ensure our public facilities have enough personnel,” Chege said.
The Woman Rep now wants part of funds from the supplementary budget to be directed towards funding of mental health at the facility.
The hospital has a shortage of beds to accommodate patients. Records indicate that although the actual number of beds increased from 574 in the 2011-2012 financial year to 768 beds in 2015-16, representing an increase of 34 per cent, there has also been an increase in the average number of patients in the wards from 596 to 906, a 52 per cent rise.
“Twenty five per cent of our outpatient and up to 40 per cent of our inpatient population suffers from mental illness. Sometimes you will be in hospital thinking you have a backache when in the actual sense the condition you are suffering from is mental,” Health PS Susan Mochache said.
Of concern is that many Kenyans still erroneously ascribe mental illness to curses, evil spirits or witchcraft. The affected persons are thus shunned in the community.