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.
