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Press Release: The World Mental Health Day: “Mental Health Is a Universal Human Right”

Kenya National Commission on Human Rights

Press Statement: Tuesday 10th October 2023​ For Immediate Release:

The World Mental Health Day: “Mental Health Is a Universal Human Right”

  1. The Kenya National Commission on Human Rights joins all Kenyans and the global community in commemorating the 2023 World Mental Health Day. On this day, we are all called upon to continue raising awareness, driving actions and implementing interventions that prioritize, promote and protect every person’s mental health as a universal human right.
  1. The World Health Organization (WHO) observes that here has been a 13% rise in mental health conditions and substance use disorders in the last decade, with 1 in every 8 people estimated to have been living with a mental health condition as of 2019. WHO also further estimates that around 20% of the world’s children and adolescents have a mental health condition, with suicide the second leading cause of death among 15-29-year-olds. There is no doubt therefore that the state of mental health has not gotten any better especially due to the prevailing global and national economic crises that continue to affect peoples’ lives and livelihoods.
  1. In the Kenyan context, the report of the Taskforce on Mental Health of 2020 pointed out that mental illness such as depression and suicide, substance use disorder, bipolar disorder, schizophrenia and other psychoses accounts for 13% of the entire disease burden in Kenya. The Ministry of Health’s Mental Health Investment Case 2021 puts the burden of mental health conditions at 62.2B annually (0.6 of the GDP) due to loss of productivity capacities. The report further revealed that the investment required for selected clinical packages and population-based preventive interventions over a 10-year period is Kshs. 81.7B or Kshs. 1,712 per capita with return on investment (ROI) over the same period being Kshs.161.6B.
  1. A human-rights based analysis of the 2022-2023 government expenditure by the Office of the High Commission for Human Rights (OHCHR) established that household out-of-pocket spending accounts for 27% of health expenditure, way beyond the recommended WHO target of 12-15%. The expenditure is much higher for the rural population. There is no indication that the budgetary allocation to the mental health sector has improved from 0.01% (15 cents) of the national health budget to the proposed Kshs. 250 per capita. The Commission is concerned that this affects negatively on access to mental health services, including early diagnosis, management and care for those that mostly need mental health service.

 

  1. The Commission acknowledges efforts to prioritize and address mental health concerns in the country through a number of interventional measures contained in the Mental Health Action Plan (2021-2025), Suicide Prevention Strategy (2021-2026), Mental Health Investment Case, 2021 and the recently launched National Guidelines on Workplace Mental Wellness, 2023. The most significant step was the enactment of the Mental Health (Amendment) Act, 2022 that identifies persons with mental illness to include a person diagnosed with alcohol or substance use disorder and a person with suicidal ideation or behaviour. The Act further provides for the rights of persons with mental illness including the right to appropriate, affordable, accessible physical and mental medical health care; counselling; rehabilitation; and after-care support.
  1. To promote and protect the rights of mental health service users, WHO launched the QualityRights initiative that emphasizes transformation of mental health services towards a person-centered, rights-based recovery approach. This framework guided the Commission in carrying out an assessment of selected mental health facilities in Kenya in 2022. The assessment report was launched in June 2023 and revealed, among others that the standard of living for service users in the mental health facilities was poor. Further, there was violation of the right to exercise legal capacity and the right to personal liberty and security of the person. Service users were not supported to live independently and be included in the community as the facilities failed to connect the service users to a range of community services and supports systems as recommended under the QualityRights framework. The report thus paints a grim picture with regards to the alignment of the various strategies and interventions to the QualityRights framework.
  1. To realize a person-centered and human rights-based approach to mental health in line with this year’s theme “Mental is a Universal Human Right”, the Kenya National Commission on Human Rights REITERATES as follows:
  • That universality of human rights includes users of mental health services and that having a mental health condition should never be a reason for deprivation of a person’s human rights and fundamental freedoms. Will and preferences of service users on decisions about their own health must be respected.
  • Calls for the implementation of the High Court judgment in Kimaru & 17 others v Attorney General & another; Kenya National Human Rights and Equality Commission (Interested Party) (Petition 226 of 2020) [2022] KEHC 114 (KLR) that put an end to detention of persons with mental illness at President’s pleasure.
  • Urges mental health facilities to create a conducive physical and social environment and end inhumane and degrading practices such as involuntary detention and treatment, coercion, violence and abuse of service users.
  • Calls for an end to detention or shackling of persons with mental health care needs, including by families, health institutions or even faith-based organisations.
  • Calls on the national and county governments to increase mental health budget and financing to realize the return on investment envisaged in the Mental Health Investment Case, 2021.
  • Advocates speedy for integration, collection and reporting of mental health indicators through the DHIS to inform mental health service delivery in the country. This will effectively bridge the current data and information gap on mental health conditions experienced in Kenya.
  • Appeals for enhancement of mental health systems and improved access to community based mental health services to respond to the needy and most vulnerable groups such as persons with disabilities, older persons, intersex persons, victims of sexual, gender-based violence, and other victims of crime.
  1. The Kenya National Commission on Human Rights continue to emphasize the need for the respect, promotion and protection of the right to legal capacity of mental health service users, taking into account their will, preferences and informed consent.
  1. Mental health practitioners and caregivers are also called upon to empower service users to lead their recovery journey through supported decision-making.
  2. The KNCHR lastly cautions all stakeholders that human rights violations have a huge negative impact on people’s mental health. For instance, discrimination, poverty, limited access to social protection interventions and lack of quality health services exacerbates social and economic barriers, leading to among others, stress and anxiety.

Access to Quality and Affordable Mental Health Services is a Universal Human Right!

 

Roseline DA Odede

 Chairperson

 Kenya National Commission on Human Rights

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