Reflections from the Christian health actors mental health regional meeting held in Limuru, Kenya 

The World Health Organisation (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. This definition brings out the centrality of mental health to an individual’s well being. The three components of health are inter-connected and affect every sphere of life.

Nearly one billion individuals globally live with a mental health condition, the most common being anxiety and depression. More than 80 per cent of mental disorders occur in low and middle income countries (LMICs). In Kenya, a staggering one out of four persons who seek healthcare have a mental health condition. Depression is common and there are increasing rates of substance and alcohol use disorders (WHO).

All people experience times of less than optimal mental well being and need compassion and support.

Mental Health Continuum Model: Where are you at?

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What can we do?

Individual responsibility

• Know the basic symptoms of mental health disorders including maternal mental health disorders.
• Adjust your personal thinking – attitudes and judgemental thinking – around mental health
• Talk openly about mental health
• Choose your words carefully
• Show compassion and respect to people with mental health disorders including women with maternal mental health disorders.
• Connect people with mental health disorders to the help they need
• Prioritize your own mental health

Maternal mental health

• Nearly one in five women in low and middle income countries suffer from one or more common perinatal mental disorders (CPMDs).
• The perinatal period (pregnancy up to two years after birth) has an increased prevalence of mental disorders.
• Mental health initiatives need to partner with key stakeholders such as faith actors to raise awareness, reduce misinformation and stigma and decrease barriers for utilising mental health services.
• Adolescent girls have unique risk factors for psychological distress such as unwanted pregnancies, poverty and oppressive gender norms.
• Peer support groups can make a difference for pregnant adolescents who are prone to mental health issues.
• Roping in community gatekeepers, religious leaders, and male champions to support pregnant adolescents

Community interventions

• Training and adaptation on integrating mental health care in PHC settings
• Raising awareness of mental health including integrated mental health messaging
• Referral mapping and securing a reliable supply chain for medication
• Special focus on people with disability who may have higher risk of suffering from mental health conditions
• Establishing Christian mental health programmes, building the capacity of faith leaders and Christian communities on mental health. The church can be a place of solace where individuals with mental illnesses can support each other and freely discuss about mental health.
• Youth dialogue, including about substance abuse
• Addressing harmful social norms

Caring for caregivers/workplace interventions

• Biblical counselling and encouragement
• Weekly devotions
• Financial management talks
• Access to financial assistance
• Insurance
• Health breaks
• Supportive work environment including supporting staff struggling with substance use and vicarious trauma
• Providing comprehensive support systems, such as access to mental health resources, regular training on stress management, and creating a culture of open communication to foster resilience and well-being among staff
• Implementing policies and procedures to ensure staff well-being
• Mental health and psychosocial support for emergency response workers and communities
• Capacity building for staff on safety and security with clear steps to follow in various scenarios; staff personal safety can be included in staff orientation
• Consideration for specific populations/staff working in hardship environments – insurance cover, evacuations, hibernation
• Standard incident reporting procedures
• Independent counselling services

Clinical interventions

• Mental health services are underused in primary health care facilities. There is need to integrate mental health care into primary care.
• Mental health disorders are associated with a range of factors: chronic illness, non-acceptance of therapy, traumatic events, pregnancy related factors and poor description of etiologic factors.
• Integrating a psychologist into medical rounds will link medical care of patients with their mental health care.
• Ensuring holistic mental health: medical, psychiatric, emotional and spiritual care, psychotherapy or professional pastoral counselling
• Working with church and community to ensure comprehensive education about the nature of mental illness
• Social support for mental health patients
• Advocacy

Challenges in accessing mental health services
1. Stigma and discrimination
2. Geographical disparities
3. Financial constraints
4. Cultural and linguistic barriers
5. Provider shortages and waitlists
6. Lack of awareness and education