Psychosis is growing in Kenya, due to drugs and substance use and delayed mental health treatment.
Had it not
been for a bold decision to seek treatment late last year, Henry (real name changed)
would have slid into the depths of what is unfolding into Kenya’s worsening
psychosis crisis.
Henry was
an alcohol consumer, a habit he had picked in his teens, stepped it up in
campus, fanned it after getting a job, before it took hold of him during the Covid-19
social lapse. It was during the pandemic stretch that he got hooked into daily
consumption.
“My friends
and I used to hire space in bars and request the management to lock us in. It
is here that I became a daily drinker. Thereafter, if I failed to take alcohol
I would not sleep while hallucinations would engulf me at night. I discovered I
was addicted at this stage,” said the youth from the Rift Valley region.
Making the
decision to seek treatment was not easy for Henry. While his drinking friends
were opposed to the idea, he was not sure how his family would react to his
openness to battle his addiction. But everything fell into place and he is at
present recovering from the condition.
“My parents
talked to my uncle who knew about the Taraji House rehab center in Nakuru after
I opened up about my decision to seek treatment. My request was accepted and I
joined the centre in December last year,” said Henry.
Henry was
clueless that he was slipping into psychosis as his addiction deteriorated. It
was after enlisting for treatment that he learned from counsellors at the centre
that his hallucinations were early symptoms of psychosis.
Psychosis
is a medical condition that experts link to mental health decay, causing
patients to lose touch with reality. In Swahili it is loosely known as mawazo ya kichaa
or kurukwa akili. It catches substance users whose declining mental
health is not treated early due to a variety of factors including self-denial,
society stigma, and policies that are not very solid on addressing addiction.
While cases
of psychosis are growing in Kenya, the condition can push patients into suicide
during the disease’s severe stages, according to Frederick Wekesa, a researcher
at African Population and Health Research Center (APHRC). But how does it
develop?
Mr SK Mwangi, an addiction counsellor.
While
substance use is either due to a mental health condition or a result of poor
mental health, its continuous use has been linked to patients experiencing a
state of perfection or delusions of grandeur.
“People
struggling with poor mental health are more likely to use substances and
sometimes continuous use of substances including alcohol is likely to lead to
mental health problems or conditions like psychosis which are in themselves
classified as mental health problems,” said Wekesa.
To trace
the origin of this condition and how a patient turns to substance use before
becoming delusional, Wekesa refers to a 2021 study conducted in Kenya, Vietnam
and Indonesia aiming to establish mental health disorders among young
persons.
It
established that six per cent of younger persons had general anxiety disorder
symptoms, two per cent had major depressive disorder, a condition that makes it
very difficult for people to relate to work and enjoy themselves.
Post-Traumatic Stress Disorder was at around one per cent, conduct disorder was
at 33 per cent while three and half of the people studied had Attention Deficit
Hyperactivity Disorder, said Wekesa.
The study
also identified anxiety and depression as the main drivers of youth mental
health disorders, and could be as a result of chronic stress due to peer
pressure, pressure at home and pressure to perform at school. Dysfunctional
families or growing up in environments where violence is likely to happen
contributes to behavorial problems, he added.
“At the
individual level it could be due to low self-esteem and bullying, including
cyber bullying. Children experiencing a lot of that are pushed to become
anxious and depressed. But you don’t look at these things independently. They
all work together in an additive way to actually cause a problem,” said Wekesa.
The problem
begins when a person experiencing anxiety or depression is lured into drugs or
alcohol by peers with the promise that the high the substances create will cure
their personal underlying issues, according to SK Mwangi, an addiction
counsellor at Taraji House Rehab.
But
substance use only awakens underlying health conditions like bipolar disorders,
schizophrenia and even psychosis, after temporarily creating a state of utopia
among users, said Mwangi, who is a recovered addict himself and has remained so
for about 18 years.
Repeated
states like these where a user experiences distorted perception of reality
leads to drug induced psychosis, causing panic, extreme anxiety and abnormal
decision making, and that can be a big problem for the individual, the family,
society and even the nation at large, he said.
“I tried to
commit suicide three times due to psychosis but luckily I was saved. Since I
became sober, I have never thought of having suicide attempts,” said Mwangi.
Rehabilitation
centres can treat psychosis although patients should be introduced to treatment
during the early stages of the condition. But these centres are too expensive
for a majority of Kenyans, where some are known to charge as much as a Sh500,000
per month.
The best
option would be prevention, and there are several ways the country can do that.
The most basic is having functional families where parents groom their children
to be assertive rather than passive, according to Mwangi.
That
includes parents teaching their children to have realistic expectations,
instead of ingraining a sense of entitlement into them. Parents should also
groom their children to have positive mindsets and attitudes, he said.
Another way
of prevention would be for the National Authority for the Campaign Against
Alcohol and Drug Abuse (NACADA) to get out of their comfort zones and into
spaces like schools to train and empower young people with knowledge about the
consequences of substance use, said Mwangi.
“The
promotional materials against substance use that NACADA is distributing in pubs
should be taken to learning institutions. They should also organize nationwide
seminars and roadshows on prevention,” he said.
At the
policy level, experts say there should be reforms aimed at ensuring there is a
drug free environment in the society including enforcement to crack down on
illegal drug trade and regulating advertisements that glorify substance use.
According
to Wekesa, Kenya has a very progressive mental health policy, but the challenge
has been operationalizing it. For instance, there are no guidelines to screen
for suspected mental health cases in public health facilities, how to put
patients on treatment, where patients can seek care as well as their rights.
“A policy
on its own is not good enough. Even with the decriminalization of suicide
attempts we still need the Attorney General to publish this so that it can be
operationalized and provide guidelines on how to treat people who have gone
through suicide attempt,” said Wekesa.