Calls for Kenya to prepare for post COVID-19 mental health crisis

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There is widespread mental anguish among Kenyans due to anxiety and fear from Covid-19

There is widespread mental anguish among Kenyans due to anxiety and fear from Covid-19, health experts are warning. And the crisis has likely not peaked just yet.

Triza Ireri, a Counselling Psychologist in Kwale County, has handled a case of a mother of a two-year old child who had come to the end of her tether. All she had, she said, was a 2kg packet of maize flour. When it would be finished, she would end her life and that of her baby. “Good thing she had the presence of mind to call the Covid-19 helpline,” says Triza. “When I counselled her, the whole crisis seemed to boil down to money. Those were two lives probably saved.”

However, Triza and other mental health professionals believe that this mother’s case might be only a drop in the ocean. Bigger problems lie ahead. The pressures resulting from Covid-19 are afflicting Kenyan citizens and it is likely the worst of mental problems is yet to come. “The fear of catching the disease, loss of jobs and income, economic pressures and being forced to stay indoors for months have taken a toll on individuals all across the country. We need to roll out a plan to mental health therapy to everyone,” Triza cautions.

While it may have been possible for those forced to stay indoors to envy essential services providers, those thoughts and feelings are misplaced. “Essential services providers are no exception,” says Triza. “The fear of exposure to the virus even as they go about their work exerts terrible pressure and anxiety on them. Moving around at night when the streets are deserted, anxiety about their significant others – all these are taking a toll on security and healthcare workers. Those that work at Covid-19 centres are doubly worried of catching the virus and infecting their loved ones. They too need counselling.”

Stigma is another dimension of the mental tax of Covid-19. Triza says those diagnosed with the disease have faced discrimination and ostracisation from neighbours. “I’ve come across cases of families with a Covid-19 patient who cannot buy food even when the patient is recovered. Shopkeepers and other merchandise sellers refuse to take their money and actually chase them away,” she says. This rejection is traumatising.

Then Triza throws open a door we had no inkling existed: “Stigma sometimes emanates from within,” she discloses. “Some people, on confirmation of their Covid-19 positive status, want to harm or punish themselves. They began to discriminate against themselves. We came across individuals who, once informed they had Corona virus, refused to go home. They wanted to go into hiding. Some became terrified of infecting their loved ones and wished to disappear.”

Triza says they talk with such a client to try and help them build internal resilience. Their families also get counselling and training on dealing with the virus and differentiating fact from the fiction coming from people. They further educate members of the community.
Triza clarifies that mental health challenges around Covid-19 are multi-faceted.

“There is a whole spectrum of problems. It involves out-of-school children, jobless stay-at-home adults, fear of infection, lack of food, and lack of rent are just a part. Covid-related fear is prevalent and has its own dynamism. There’s even fear resulting from the fact that the disease is new. The images from outside countries – the number of Americans dying per day, mass graves in Brazil, leaders falling ill and celebrities dying – these brought fear and have caused a lot of anxiety.”

Triza singles out children who missed their national examinations this year as particularly in need of therapy. “They are at home and this is not a brief change of routine,” she says. How about the issue of teenage pregnancy which has reportedly spiked during the period? “I cannot say that sex is for them a way of coping. I can say that they don’t have a structured life any more. They have a lot of idle time repeated month after month. This can make them focus on social aspects. Under no supervision, they’re tipping towards sex.”

She calls for a national response to the mental stress of Covid-19. Everyone, she says, should undergo therapy. The government has a rare opportunity to prioritise mental health, sensitise citizens and ensure implementation of existent policies. “We would want every citizen to measure up to the World Health Organisation’s definition of health,” she says.
Health, according to WHO, “is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

Daniel Nyule, a Mental Health Clinician in Tana River County, concurs with Triza on the mental strain of Covid-19 on essential services providers: “We even began to fear each other. When we health workers meet our colleagues working in the isolation wards, we become anxious about our safety. If we, with all our knowledge, can be fearful and anxious, how much more so members of the public?”

Daniel says he used to serve an average of 200 clients a month at his clinic. Covid-19 has driven down that number to forty. “Jobs and businesses collapsed. The poverty index has risen. Fear pervades everything.”

He believes the government is partly culpable in spreading fear. “The fear may have come from Covid communications by the government. The handling of the sick, the forced quarantines, and the burial of the dead by people gowned like aliens – the government seems to have exaggerated. In the process they transmitted fear.”

Among the people with unusual sicknesses Daniel has attended to was a woman with incessant headaches. In trying to get to the root of her problem, it seemed that the headaches were related to anxiety over money. She was helped and the headaches disappeared.

Daniel speculates that Kenya might be looking at widespread mental problems in the not very distant future. “We need to roll out a general therapy, especially for students whose examinations were postponed. The government could come up with a school-based programme. I think this disruption of their lives is going to disturb them.”

He also urges the government to come up with a way of financing households. “When schools reopen and parents are jobless, we could witness widespread manifestations of mental illnesses,” he says.

“I advocate the use of local administration to encourage people to seek therapy. It’s important that the government encourages people to rescue their lives. County governments should create mental health teams to scan the whole population. We’re likely to witness a spike in alcoholism and drug abuse.”

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