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Mental Health

Dr.Frank Njenga: The case for mental health in the country

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Dr Frank Njenga has been a psychiatrist for over four decades and has been an integral part of many mental health interventions in the country. In this special feature, HARRIET OGAYO picks his mind regarding the state of mental health in the country and what more can be done.

You have been a mental health professional for decades. From your assessment, what is the state of mental health in Kenya?

I believe we are on the right track with regards to addressing mental health disorders and creating awareness. Just recently the president passed the mental health amendment bill so we now have an act of parliament that dictates the framework around which mental health will be addressed. It’s a big deal because it’s something we had been working on for the last 10 years.

It’s one of the recommendations that we had put down in the Mental Health Taskforce Report, which is available online. The government asked me to chair the taskforce and we went around the country and found high levels of mental health disorders but very low levels of investment in mental health care. We put up 15 recommendations, some of which we achieved such as the new International Mental Wellness Hospital in Ngong which was commissioned by the president recently, and the bill.

Beyond the policies and state interventions, what else have you observed?

Aside from what the government is doing, the good news is that among the youth, the stigma associated with mental health is not as it was in the past or with people my age. They are more open to talking about it and seeking treatment, which is a good thing.

However, there are more triggers than in the past and the numbers speak for themselves. We are witnessing that by age 14 some of these disorders start to manifest which means there is still more to be done regarding mental health interventions.

We are also about to launch the Investment Case for Mental Health, which provides evidence that investing in mental health has good returns for everyone. It contains a whole gamut of things ranging from creating resource materials for teachers on how to recognise mental health disorders in students, to training people who will help youngsters deal with their problems.

That raises an important concern on access to mental health care which many feel is a preserve of those who can afford private healthcare. Is this assumption correct?

No, many things are not accessible to poorly-resourced areas. That applies to education, health, transport and so many other things; that’s just how society is structured. The important thing to note is that it is the government’s responsibility to ensure that there is equity and that the largest possible number of people have access.

How about the practitioners in the country? Are you concerned that as mental health awareness becomes more common, it raises the issue of under-qualified mental health workers?

In Kenya, we are not as badly off as people think. We have many universities training psychologists and psychiatrists and I believe we have the capacity to train them sufficiently. What we definitely need is more practitioners, but we are not desperate.

And what would you say is the scope of mental health disorders, considering most conversations tend to focus on depression?

Well depression is, of course, the most common, coupled with anxiety. They normally present together. However, there. are others that are more common but not well known or diagnosed such as PTSD, ADHD, ADD, substance abuse disorders caused by use of alcohol and cannabis and many others. Some of them are present in both adults and children and could have a number of triggers.

There are people who posit that the rise of mental health disorders can be traced back to the breakdown of the family unit; does that thought hold any water according to you?

It is a knife that cuts both ways; mental disorders lead to a breakdown of families and family breakdowns lead to mental disorders. Any kind of stress within the family structure can, and does, lead to mental health issues, and families are breaking up more often these days. The reality is that we do have a lot of social strife and family difficulties which certainly could explain some cases.

What can be done at family level to help with mental disorders then?

We can encourage conflict resolution among families and it’s not just by going to psychologists or psychiatrists. It can also involve traditional methods of conflict resolution by consulting elders in the family, you can also opt to go to church or to imams.

How about at the individual level?

The important thing at the individual level is the recognition when things are not going right and seeking help. It is not a sign of weakness.

Finally, as a society, how can we do better with regards to mental health interventions?

We owe it to ourselves to learn more about mental health. We must normalise conversations around it, specifically saying that having a mental health issue is not a weakness. We need to also normalise conversations around help-seeking behaviour. That, for me, is key.

 

This article was first published in our September 2022 issue: https://epaper.parentsafrica.com/issues/september-2022

Cover Story

Growing up while caring for aging parents

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You’re in your twenties or early thirties, still renting a bedsitter or sharing a one bedroom with a roommate. You juggle two side hustles and a job that barely covers rent and data bundles. Your salary comes in and half vanishes on fare, food and airtime top-ups before the month even starts.

Then your phone rings.

It’s Mum. Her voice is softer than usual.
“The knee is paining again. The doctor said I need new medicine but the bill…”
She trails off because she doesn’t want to finish the sentence. You already know what comes next.

Or its Dad, the man who once sent you pocket money while you were in campus, now asking quietly if you can send something small for electricity tokens because the prepaid meter is blinking red again.

Your chest tightens. Not just because of the money (though that’s part of it) .But because suddenly you hear the clock ticking louder.

They’re getting older. The strong hands that carried you. The back that bent over charcoal stoves to cook for you. The feet that walked kilometres to pay your school fees. Those hands shake now. That back is curved. Those feet tire faster.

You’re supposed to be the one helping now. That’s how it’s meant to go in our families. You finish school, get a job and start sending money home. You lift them the way they lifted you.

But what if you’re still drowning? What if getting it together feels like a finish line that keeps moving further away every year?

The fear is heavy.

You lie awake calculating. Rent is due. An M-Shwari or Fuliza loan repayment is pending. Your own medical cover lapsed last month. And now Mama needs money for a specialist visit. You send what you can. Perherps two thousand shillings and feel like a failure for the rest of the week.

Every time they say, “Pole, it’s okay. God will provide,” it stings more than if they had scolded you.

You start avoiding calls sometimes. Not because you don’t love them, but because picking up means hearing the tiredness in their voice and knowing you can’t fix it yet. You scroll job sites at two in the morning, apply to everything and pray for one breakthrough that will let you breathe and send real help home.

But the breakthrough is slow in coming. Meanwhile, arthritis is winning, blood pressure is rising and the village clinic queue is getting longer.

The fear

There’s the fear that they’ll suffer in silence because they don’t want to burden you. . The fear that you’ll never give them the easy life they sacrificed for.

And the deepest fear of all; that they’ll leave this world thinking they failed you, when really you feel like the one who failed them.

Even in the middle of that panic, there are small truths worth holding onto.

What keeps you going

Your parents didn’t raise you to be perfect. They raised you to try. They know you’re hustling. They see the late nights, the side gigs, the way you stretch every shilling. When you send one thousand instead of ten thousand, they don’t see failure. They see effort.

You are not late. You are in process. The economy is brutal, opportunities are few and the cost of living keeps rising but that doesn’t mean your love is small. Love shows up in the five hundred shillings of airtime or M-pesa you top up and in the weekends you go home empty handed but stay the whole day washing clothes, cooking and sitting with them.

One day, maybe sooner than you think, the season will shift. You’ll land the better job, clear the debts and start sending consistent help. You’ll take them to that private hospital, buy the good medicine and fix the leaking roof.

But even before that day arrives, you are already honouring them by refusing to give up.

Your parents didn’t keep score when they were raising you.
They won’t start now.

Keep going.
They’re still proud.
You’re still becoming even if it’s taking longer than either of you hoped.

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Cover Story

The version of you that only exists at home

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“I am an adult everywhere, except at home.” If that line hits with a mix of recognition and quiet discomfort, you’re not alone.

You step through the door of your childhood house or the family home you still visit. The capable adult you have become starts to fade almost instantly. Your shoulders drop. Your voice softens. You apologise before anything goes wrong. Suddenly you feel twelve again. You scan for approval. You brace for the familiar scorecard that lives only in this kitchen.

Why this happens

This is not pretending. It is regression wired deep. Family homes are the original emotional operating system. No matter how far you have come with therapy, career wins or independence, certain smells, sounds or sighs trigger version one of you. Old scripts replay automatically. You hunch at a particular sigh. You rush to prove yourself. You laugh too sharply at an old nickname.

The patterns formed when your nervous system was still developing. In homes with inconsistent love, high criticism, unspoken rules about emotions or where you adapted early to stay safe or seen, those survival strategies became muscle memory. Love felt conditional. Mistakes brought shame. You learned to read moods and shrink yourself. When the original cues return, the body remembers before the mind does.

The family’s role

Often the family has not updated their view of you either. They still see the child who spilled juice or the teenager who slammed doors. Two outdated versions try to connect. Instead of ease you get glitches. You feel too much and not enough at once.

Finding your way forward

Awareness is the turning point. Naming it steals half its power. You can observe the old role without fully stepping in. You can choose new responses. Even if they start silently, you can think, “I am not that twelve year old anymore.”

Some people carry the home version forever. That is okay if it does not cost their peace. Others learn to visit as adults. They love. They help. They do not hand over their selfworth.

The most healing path happens when the family updates together. A parent says, “You have become extraordinary,” and means it. A sibling drops childhood jabs. The house stops feeling like a courtroom.

Until then, know this. Shrinking a little when you walk in does not mean you are broken. It means you are human. You are wired for belonging even when belonging stings.Next time the throat tightens, breathe. Look around. Whisper to yourself, “I am an adult everywhere. Including here.” .

Watch how slowly and stubbornly the younger ghost steps back.

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Mental Health

Why Celebrating Small Wins is Better for Your Child’s Mental Health

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Children don’t progress in large or uniform strides; they move in small, jagged intervals. Those moments mean a lot to their development and growth.

When parents acknowledge the little successes, children feel valued, which in turn supports their emotional well-being and contributes to enhancing their confidence over time.

Successes, however small, create confidence

Making their bed on a rough morning, having another try after a mistake might be a small thing, but they represent big wins for your child. They don’t have to be perfect to succeed when their effort is noted and appreciated. Their confidence grows from trying and being their true self, not just from achieving the desired results.

Reduced pressure leads to reduced anxiety

When we emphasise big wins, children can feel afraid of failure and give up. Observing their victories, however small, sends a different message; mistakes are part of the learning process.

This evens out your pressure and helps you calm down. You notice this same idea in your children’s books: try new things, make mistakes and just keep on going.

Progress doesn’t always follow a straight path

Children show progress, withdraw, and move sideways, sometimes all in the same week. A child can have a happy school day one day, the next day be sad or angry, and not want to wear their school uniform.

When parents recognise something good even on a rough day, it helps them to know that one bad moment doesn’t make all the other good moments go away. That perspective can support a healthier mindset.

Recognising skills allows emotions to grow

If a child pauses to react, names a feeling, or asks for help, they are learning. Acknowledging these moments helps cope healthily. With time, children learn how to regulate their emotions and manage them effectively.

Some children find small successes important

For children with anxiety, neurodivergent or low self-esteem, progress can sometimes feel like a difficult task. Acknowledging any of their accomplishments can help them realise that every effort counts.

It can help their mental health for a long time at a later stage.

A small acknowledgement can have a big impact

Celebrating wins doesn’t have to involve a gift or a pat on the back.  At times, a smile, a word of reassurance or a moment of pride is enough. The critical thing is that the child feels truly seen.

Having fun together deepens connections and intensifies motivation.

When parents make small celebrations, children understand that growing up is more important than being perfect. They realise they are worthy of value for who they are becoming, rather than what they do.

Such an understanding builds emotional resilience that will remain throughout their entire life.

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