BY WINNIE OSIKA
Worldwide, depression has been identified as the leading cause of ill health and disability.
In April 2018, a young Chuka University student took his life after writing a suicide note to his girlfriend, accusing her of cheating on him. Around the same time, a young college student committed suicide at Kibauni location in Mwala, Machakos County. The number of suicide cases has been rising at a worrying rate over the years. In 2017, 421 people committed suicide, a 58 per cent increase from 2008. Data released by the Kenya National Bureau of Statistics (KNBS) indicates that more Kenyans committed suicide in 2017 compared to 2016. Social media and newspapers are awash with stories of suicide incidences involving people of all ages from all communities in Kenya. This trend is worrying and the most probable driver is depression. A World Bank report released in 2017 shows that a total of 1.9 million depression cases were reported in Kenya by 2015. The report ranked Kenya as the sixth country with the highest number of depression cases among African countries.
Depression leads to suicide
According to the World Health Organization depression is a mental disorder, which leads to persistent sadness, a loss of interest in pastime activities and an inability to carry out daily activities for at least two weeks. The condition has been attributed to a complex interaction of social, psychological and biological factors. People who have gone through adverse life situations such as unemployment, bereavement, broken relationships, financial problems, chronic pain, illness and psychological trauma are most likely to suffer depression. At its worst, depression can lead to suicide. WHO estimates that close to 800,000 people die due to suicide every year, and this is the leading cause of death in 15-29 year-olds. In Kenya, depression is the greatest driver to suicide. Worldwide, depression has been identified as the leading cause of ill health and disability. More than 300 million people are now living with depression, an increase of more than 16 per cent between 2005 and 2015.
High suicide rate in men
Nationally, 421 suicide cases were reported by the police in 2017, compared to 302 in 2016, according to the KNBS economic survey. Out of the 421 cases, 330 were men. World population review in its survey states that Kenya’s suicide rate is at least 6.5 suicides per 100,000 people. These statistics are worrying, and it is true as WHO notes, that there is a gap in awareness creation on suicide as a major public health problem. As a result, some communities still believe it is a taboo to openly discuss it. Further, only a few countries have included suicide prevention as a health priority and only 28 countries around the world have a national suicide prevention strategy. Kenya, for example, is among the 28 per cent of WHO member states that do not have a separate budget for mental health.
No quality mental health services
Mental health services in Kenya are highly underfunded and this has been a major impediment to the development of quality mental health services in the country. This is according to Kenya Mental Health Policy report (2015-2030), under the Ministry of Health. The report estimates that up to 25 per cent of outpatients and up to 40 per cent of in patients in health facilities suffer from a mental condition. Further, the probable prevalence of psychosis in Kenya is at an average of one per cent of the population. The policy report further reveals that the most frequent diagnosis of mental illness made in general hospital settings are depression, substance abuse and anxiety disorders.
Depending on the number and severity of symptoms, a depression episode can be categorised as mild, moderate or severe. Generally, people with depression suffer from anxiety, reduced concentration, indecisiveness, guilt, hopelessness and thoughts of self-harm or suicide. Other symptoms associated with depression are a feeling of worthlessness, restlessness, sleeping more or less, change in appetite and loss of energy.
Need for awareness
Depression is still discussed in low tones and this points at low acceptance levels of the condition as a disease that requires treatment. Many teens opt to take to social media to talk about it, but even after coming out, they still receive a backlash from society. In most cases, people may think the depressed person is seeking “attention.” It is only after one has committed suicide that society begins piecing together the past. Raising community awareness and breaking down the taboo is key if countries are to make progress in preventing the stigma associated with mental illness and suicide.
Two among the key priority action areas in the Kenya Mental Health Policy is increasing the budgetary allocation to mental health services to a minimum of the recommended WHO standards both at national and county health sector budgets; and establishment of community health financing programmes to support mental health services. The policy recommends that all persons with mental disorders should have equitable access to health care at the highest attainable standards. In accordance with section 9 of sub section 2 of the Mental Health Act 1989 Cap 248 of the laws of Kenya, all general hospitals are required to admit and treat persons suffering from mental disorders.
Winny Osika is a freelance journalist based in Nairobi. Email: firstname.lastname@example.org