There is something different about the surroundings here—this is the first thought that crosses Patience Adhiambo’s, not her real name, mind as she stands just inside the gate of a place she never imagined stepping foot in.
The gate behind her is safely locked a stark contrast to the freedom she had just moments ago. Yet, she chuckles softly, whispering to herself, “I am a voluntary case".
This moment is surreal. Just a few months ago, she was diagnosed with Bipolar 1 Disorder and managed as an outpatient.
But today is different. She is here as an inpatient, seeking more structured care.
The weight of what led to this moment sits heavily on her chest, but she shakes her head as if to push those memories away.
All she knows is that she is deeply depressed, and even the energy that brought her here is fast depleting.
At the reception, a nurse greets her with a warm yet professional demeanour.
The process is swift—within five minutes, she has signed documents confirming her voluntary admission.
Still, her body refuses to relax. She wants to convince herself that her restlessness is just from the wait, but she knows better. She has been restless for over a week now. The anxiety is unbearable.
She closes her eyes, reminding herself to breathe. "In through the nose, out through the mouth," she whispers.
This has been her mantra lately, a lifeline when her thoughts spiral out of control.
Settling in: A new routine begins
It is 8 am, and the day’s structure is already in motion. A nurse guides her to the station for preliminary checks.
Blood pressure, glucose levels, weight, and height—each measurement is taken with care.
“Make sure to drink more water,” the nurse advises as she hands her the schedule for the day.
The paper feels heavier than it should in her hands. It is an outline of how she will spend the next few days.
A nurse then leads her to the room that will be her home for the next seven days.
The space is simple yet functional—a well-sized room with two beds, each accompanied by a bedside table.
“You can either rest here or try going outside. There are comfortable shades,” the nurse suggests before reminding her to follow the schedule. “Good luck.”
Adhiambo nods, placing her belongings on one of the beds.
A glance at the schedule tells her that she has thirty minutes before her first activity.
She debates whether to stay in the room or venture outside. She knows that staying alone with her thoughts might make things worse, so she forces herself up and follows a path leading to the shaded sitting area outside.
The air is fresh, the lawns are neatly trimmed and the environment is peaceful. She chooses an empty shade and sits there, trying to absorb the tranquillity.
Facing the diagnosis: The weight of therapy
Soon, it is time for her one-on-one session with a psychiatrist. She finds her way back to the nurse’s station, anxiety creeping in with every step.
As she waits outside the doctor’s office, she fidgets, her breathing shallow. The unknown is terrifying.
When she is finally called in, the session unfolds as she expected.
The psychiatrist starts with familiar questions about her background, family and medical history.
Then come the more personal ones—how has she been feeling over the past week? Has she been sleeping well? Is she experiencing anxiety? What thoughts have occupied her mind? Emotionally and physically, how does she feel?
She answers each question truthfully, though some responses come with difficulty.
The psychiatrist listens intently before prescribing medication to help her cope. The morning and evening doses will become a part of her daily routine.
Twenty minutes later, she steps out, feeling a strange mix of relief and exhaustion.
At 11 am—tea break, the dining hall is filled with other patients; some engage in quiet conversations while others sit alone, staring into the distance.
She picks a cup of tea and a croissant but barely takes a bite. Her appetite has been non-existent for days.
Seeking connection: Finding light in darkness
At noon, she joins the others for group therapy. The session is held outside under a large shade. At least twenty people have gathered, some with bandaged hands, others looking lost in thought.
The psychologist leading the session greets them warmly before diving into the day’s topic—stress. They discuss negative stress, good stress, common stressors and coping mechanisms.
As the session progresses, Adhiambo realizes that she is not alone. Some of the people here are battling addictions, while others, like her, are dealing with mental health disorders. A silent understanding forms between them.
After therapy, Adhiambo skips lunch and retreats to her room. She sets an alarm for 3pm, hoping to rest, but sleep doesn’t come.
Her thoughts are relentless. The weight of her struggles presses down on her chest. By the time the alarm rings, she feels no better, but she forces herself out of bed.
The next activity is social time. She follows the directions to an open shed with two pool tables and a table tennis court.
A young man approaches the tennis table, and knowing he needs a partner, she gathers the courage to ask if she can join. He agrees. They introduce themselves before starting the game.
Time flies. The distraction is welcome.
A soft melody starts playing nearby. "Still social time but with a different activity," her playmate tells her. It is a Zumba session. She chooses to sit it out and returns to her room.
Mental healthcare beyond the facility
As the day winds down, she undergoes more tests at the nurse’s station before taking her medication. Supper is served at 7 pm, but she only eats a fruit before retreating to her room.
By 9 pm, a nurse knocks on her door, handing her the nightly dose.
Lying in bed, she reflects on the day.
"Yes. There is something different here. It is peaceful, and the air is clean and soothing," she whispers.
Yet, she knows that access to inpatient mental healthcare is a privilege.
Outside of government facilities, treatment is expensive.
She wishes for better access to therapy, not just for patients but for their families and caregivers as well.
"Living with a mental health disorder is like living inside a cage that you are not sure when it will close in on you," she tells the Star, during an interview two months after getting discharged.
For now, she clings to hope. Hope that healing is possible. Hope that, one day, no one will have to fight this battle alone.
Need for care, for caregivers
“There is a need for cheaper services to manage these issues. There is a need for therapy for the family and caretakers of the affected persons too,” Odhiambo says.
The impact of mental health on caregivers ranges from emotional to financial strain. Caregivers often experience a range of emotions, including stress, anxiety and sadness.
The emotional burden can be overwhelming, especially if the caregiver feels unprepared or unsupported.
Additionally, the demands of caregiving can lead to social isolation. Caregivers may have less time to spend with friends and family, which can contribute to feelings of loneliness and depression.
The physical demands of caregiving, such as lifting or assisting with daily activities, can lead to physical exhaustion.
This can further impact the caregiver's mental health, as they may feel overwhelmed and unable to cope.
Furthermore, caregiving can also have financial implications, which can add to the stress and anxiety experienced by the caregiver.
