State allocates less than one cent to mental health – report

Despite much buzz about mental health, the government barely factors it in the health budget, a report by civil society groups has shown.

The detailed report forwarded to the UN ahead of the fourth cycle of the peer review mechanism shows that the government only allocates 0.001 per cent of the national health budget towards mental health annually. This is against the globally recommended level.

The impact of this is that the country faces significant gaps in mental health service delivery at the national, county and community levels, and that a majority of Kenyans have been driven into poverty due to out-of-pocket payments for mental healthcare services.

The amount of money that ought to be spent on mental health is $1.16 (Sh150) per capita but Kenya is spending $0.0012 (less than a cent), the report sent to Geneva shows.

Additionally, inadequate national health budget allocation that falls short of the recommended WHO guidelines and Abuja Declaration recommendations of five per cent and 15 per cent also affected mental health financing.

In the 2022/23 budget, the health sector at the national level was allocated Sh123,003,365,307.91 which translated to 3.69 per cent of the total budget and 0.97 per cent of the GDP.

The Universal Periodic Review is a process that allows UN member states to assess each other’s human rights records and it takes place every four and a half years.

The third cycle took place in January 2020. The fourth cycle is upcoming. Other than financial issues, the lobbies finger shortage of specialised mental health professional and widespread stigma associated with mental illness and conditions in the country.

It also cites legal hurdles including problematic clauses such as Section 226 of the Penal Code that criminalises attempted suicide, partial implementation of Mental Health (Amendment) Act, 2022, and Kenya Mental Health Policy (2015-2030) which cumulatively limit access to quality mental health services.

However, a court recently quashed the section of the penal code that made attempted suicide a penal offence after advocacy.

“These obstacles deter mental health patients from seeking help and perpetuates the cycle of inadequate care and poor mental health outcomes across the country,” it reads.

During the 3rd UPR cycle review in January 2020, Kenya accepted the recommendation from Ecuador to finalise the adoption processes of the draft bills on children, mental health and persons with disabilities and consider ratifying the Optional Protocol to the Convention on the Rights of Persons with Disabilities.

The report states that the country has made significant progress on that front but still has a huge shortage of professional specialised in handling mental health issues.

For example, they say, the country has an estimated 100 psychiatrists, which translates to a psychiatrist per a million people. Worse, these specialists are not available to the public as most of them are concentrated in the private sector.

“The concentration of specialists in private practice within Nairobi reflects a broader national disparity and highlights the shortage of specialised mental health practitioners nationwide.”

According to Ministry of Health guidelines, Kenya needs 1,400 more psychiatrists, 7,000 more psychiatric nurses and 3,000 more psychologists.

“Many trained mental health professionals work outside the public sector; of Kenya’s 92 psychiatrists and 427 psychiatric nurses, only 36 (39 per cent) and 187 (44 pe rcent) are employed in public facilities. These rates are way below the globally quoted minimum psychiatrist-to-patient ratio of 1:10,000 with a recommended pragmatic ratio of 1:8000 for the foreseeable future,” the report states.