The 32-year-old single mother, had joined her family for a late lunch in Uthiru, Kiambu county. After playing with her cousins for half an hour, her daughter excused herself to use the toilet and did not return.
Rose, whose name has been changed for privacy, found the child cowering on her grandmother’s couch.
“She was sweating and heaving bitterly as if somebody had hurt her,” she says.
For weeks Rose had noticed subtle changes in her daughter’s behaviour, which she dismissed as typical of girls entering puberty. Yet, as days turned into weeks, she couldn't shake the feeling that something more profound was at play.
Her daughter, once a bubbly and energetic child, slowly became withdrawn and quiet. Her mood swings intensified. Some days, she would be excessively irritable, while other times, she appeared listless and unresponsive.
Last year when this happened, Rose knew her daughter was sick. The search for help took her to an unfamiliar territory of paediatric psychiatry.
In January this year, after many visits to the Kenyatta National Hospital’s outpatient paediatric clinic, Rose's daughter was diagnosed with anxiety and depression, emotions that seemed inconceivable for someone so young.
The road to healing has been challenging. Therapy sessions have become a regular part of their routine. Slowly, Rose has learned to navigate the complexities of parenting a child with mental health challenges.
Dr Caroline Vundi is a psychiatrist who says she has lived experiences of grief, depression and anxiety.
In 2018, Dr Vundi sought to establish patterns of mental health disorders among children and adolescents with physical illnesses at the KNH’s paediatric outpatient clinic.
She said that most mental health disorders that begin in a child are often detected later in life, leading to poor outcomes.
Nearly one in every three (29.6 per cent) of the 248 respondents whose guardians consented to her study at KNH screened positive for at least one mental health disorder.
The youngest participant was six years old and the oldest was 15, Dr Vundi said. Most of the participants were in Grade 1 to 5 and most if the participants’ parents (75 per cent) were married.
“Participants in pre-primary had a higher likelihood of screening positive compared to those in lower primary and upper primary,” she said in the study, titled 'Prevalence and patterns of mental health disorders among children and adolescents with physical illness at the outpatient department of Kenyatta National Hospital.'
“The most common disorders were eating disorders, movement disorders, attention deficit hyperactivity disorder and conduct disorders.”
Dr Vundi, however, said thas - this being a hospital study- it could not be generalised to the general population.
Nevertheless, she said childhood mental health is neglected in Kenya and such disorders are not routinely screened for in hospitals.
The World Health Organisation says worldwide, 10 per cent of children and adolescents experience a mental disorder, but the majority of them do not receive care.
The exact cause of most mental disorders is not known, but there is some evidence heredity, biology, psychological trauma and environmental stress, might be involved, WHO says.
The Kenya Mental Health Policy 2015-2030 does not provide any statistics to show the extent of mental ill health among children in Kenya.
However, the policy indicates this is a vulnerable population.
“Children are often prone to mental disorders either at birth, where there might have been inadequate pre-natal care, or if their environment does not promote care, affection, love, stimulation for cognitive abilities or other emotional and social support,” the policy says.
The policy says the government shall establish “targeted, accessible and friendly services for the vulnerable groups.”
Other children-related laws hardly mention their mental health.
The Children Act 2022 only mentions mental health of children when minors are involved in crime.
Health Cabinet Secretary Susan Nakhumicha says the Dr Frank Njenga-led task force on mental health identified children and adolescents as a special population in mental health who require targeted intervention.
“To address this, we have established National School Mental Health Technical Working Group to improve the collaboration and coordination of school mental health interventions, including the development of national guidelines on school and mental health,” CS Nakhumicha told the National Assembly in October.
Nominated MP Irene Mayaka said in Nyamira and Kisii, where she comes from, there are regular news of children committing suicide.
She suggested mental health, guidance and counselling should become part and parcel of the timetable in schools.
Nkhumicha agreed. However, the CS said curriculum development is a function of the Ministry of Education.
“We shall be working together with them to see how we integrate guiding and counselling specifically to work on mental health and see how it can be put into the curriculum,” the CS said.
Kenya recently enacted Mental Health Amendment Act 2022 that amended the outdated 1989 Mental Health Act. However, the amended Act still does not mention the mental health needs of children.
Kenya has promised to amend it and other bills on children by 2025 when the country will be grilled on these promises by the UN Human Rights Council during its fourth Universal Periodic Review.
This is a process through which all UN member states are provided the opportunity to review the human rights records of all other member states.
The process allows the sharing of best practices among states and other stakeholders and ultimately aims at the improvement of the human rights situation nationally.
Rose, whose child is getting better through therapy and medications, is lucky she can afford this care.
