Many events around us seem to suggest that a mental health cataclysm is unfolding within our borders with the Covid-19 pandemic serving as a catalyst.
The reported cases of homicides and suicides are particularly worrying. Kenyans both online and offline are showing visible signs of anger, anxiety, aggression and defiance.
Our mental health is taking a historic assault and our survival will be contingent upon renewed attention to mental health at the personal, community and government levels.
Mental health and physical health are fundamentally linked. The mental health effects of the Covid-19 pandemic include fear of the contagion, anxiety, depression, risk of post-traumatic stress disorder, suicidal behaviour and a relapse of many pre-existing mental illnesses.
The increased burden of mental disorders is due to the stresses caused by the many losses that people have to live with due to the pandemic, particularly loss of income.
Recent studies indicate that the SARS-COV-2 virus can directly attack the brain resulting in a number of neuropsychiatric symptoms such as confusion, headache, memory loss and bizarre behaviour.
Diseases ranging from stroke, psychosis and dementia have been reported in patients recovering from Covid-19. It may take many years of longitudinal studies to determine the full outcomes of these illnesses.
Measures enacted by the government to control the spread of Covid-19 evidently elicit more fear among the citizens than the virus itself and bring an additional potent threat to mental health.
When people’s freedom is limited and their sociocultural practices impeded, mental health is negatively impacted. The more prolonged the measures the greater the mental distress.
Kenya has been on partial lockdown to varying degrees for over a year and the strain on people’s lives is written on their faces. The economic turmoil occasioned by the closure of restaurants, churches and sports and entertainment activities has led to loss of both livelihoods and the benefits of social congregation.
In the long term, persons who have been negatively impacted by a disruption of their livelihoods will remain vulnerable to mental ill-health, which has an established vicious and cyclic relationship with poverty.
Needless to say, many of the containment measures such as the curfew have been carried out in a cruel and extortionist manner. This opens a new risk to people’s mental health. Coercion from government security forces undermines solidarity and community trust in government messaging and poses a risk to the entire Covid-19 strategy.
It is not uncommon to hear Kenyans dismiss the entire pandemic as a propagandist tool for government oppression and corruption. This speaks to disproportionate use of the control measures and the consequent disaffection and disillusion.
If indeed the supposition that the SARS-COV-2 virus will be spreading in our communities for many decades to come, focus should begin to shift to long-term measures.
Continuous public education on how the disease spreads and ways to prevent infection should be part of our daily devotion; availability of free and voluntary testing; expansion of our health facilities including specialist units to deal with the disease and large-scale free vaccination should become a priority.
We should also make preparation on how to deal with the ensuing long-term mental health consequences of this pandemic. Public health measures should employ persuasion rather than a ‘state of emergency’ type of coercion.
It is by far more beneficial to educate citizens on how to protect themselves from infection than allow them to take personal responsibility. For behaviour change to be permanent it should be intrinsic rather than when it is instilled through coercion, threats, barricades and guns.
The measures themselves, even when necessary, should not be prolonged and indefinite – which creates a sense of hopelessness that is toxic to mental health. Restrictions that are no longer necessary should be lifted.
To avert the approaching mental health disaster in Kenya, the government should develop a national mental health response plan to Covid-19.
This plan should include a nationwide survey to establish mental health challenges afflicting Kenyans during this pandemic. The training and support of community health volunteers to deliver psychological first aid to Kenyans in distress should be prioritised.
Mental health experts should be co-opted onto the national emergency response committee to guide it on strategies to address the mental health consequences of the Covid-19 pandemic.
To ensure access to the highest standard of mental health recommendations in the national mental health task force report should be implemented.
President of the Kenya Psychiatric Association
