MENTAL HEALTH POLICY REFORM IN KENYA: A CASE STUDY OF UNIVERSITY OF NAIROBI, COLLEGE OF HEALTH SCIENCES

Abstract

Mental health policy reform in Kenya is important because of the growing burden of mental health conditions, ongoing gaps in the health system and changes in the socio-economic environment, such as the psychosocial effects of the pandemic and rising substance use. Key challenges include insufficient financing, ineffective integration of mental health into PHC, workforce shortages, stigma and spotty implementation across the counties. Addressing these challenges is necessary to strengthen prevention and early intervention, improve the efficiency of the systems and ensure the constitutional right to the highest attainable standard of health. The College of Health sciences at the University of Nairobi is best placed to support mental health reform through research to inform policy, developing future leaders in this field and supporting improvements in the health system. Through academic-government partnerships, capacity building initiatives and policy relevant scholarship, the College helps to support equitable, people-centered and sustainable mental health services in support of national priorities and the best practices from around the world. Three major strategies for reforming have been identified: specialist-centered services, separate mental health facilities and integration into primary health care. While specialist and standalone models play an important role for severe cases, it is limited by disproportional access to them as well as the underutilization of community-level resources. Integration of mental health into PHC appears to be the most feasible, cost-effective and scalable option. This model increases access, early detection, decreases stigma, improves continuity of care, and builds on existing service models and response at the community level. For the University of Nairobi-College of Health Sciences, the inclusion of MH in PHC is in line with the agenda on Universal Health Coverage and contributes to the institutions mandate of producing competent and responsive health professionals. It allows the College to generate evidence specific to the context, build workforce capacity to address the challenges and engage in policy dialogue with national and county stakeholders. Furthermore, this approach enhances leadership and governance processes by improving institutional agility, responsiveness and interdisciplinary working while incorporating mental health competencies into pre-service and in-service education.

Keywords: Mental Health Policy Reform; Primary Health Care Integration; Universal Health Coverage; Mental Health Services; Leadership and Governance