At exactly 11.40 am on Tuesday, October 6, Riziki Nyariri Ekumbo stepped out from the elevator to the lobby at a high-end hospital with bright eyes. The hospital in the Lavington area in Nairobi is an exclusive facility for mental health patients.
Her face mask was on, but when she ripped it off to acknowledge greetings, her smile was even brighter and broader, and could not reveal any troubled past.
The light-skinned woman wore a bright pink and white-striped blouse that matched her smile. Close to her chest, she clutched a notebook piled neatly together with a small envelope, a glass case, and a cup of coffee on the other arm.
From the outset, one could tell she is a stickler; timekeeper and highly sensitive about cleanliness. Among the outstanding features in the compound of the hospital are about four gazebos standing on a well-kept lawn where patients meet their visitors.
“Let’s settle in one of those gazebos,” she pointed to one of the vacant facilities with two seats.
As the interview kicked off, she pointed out the possibility that there could be so many people out there who are not aware of their mental health status.
On her part, Riziki is overcoming acute depression that saw her lose hope of completing her undergraduate education despite being just a unit away.
However, she is currently being treated for suspected Attention Deficit Hyperactivity Disorder (ADHD) which is yet to be diagnosed although Riziki has noticed tell-tale signs.
ADHD is a mental health disorder that can cause above-normal levels of hyperactive and impulsive behaviours.
“I realised I am obsessed with stuff such as cleanliness; neatness and arrangements, which my doctor described as a condition sometimes known as Obsessive-Compulsive Disorder (OCD), a mental disorder in which a person feels the need to perform certain routines repeatedly.
“I think I have been suffering from depression from childhood but I did not know what it was because the symptoms I had were low self-esteem, social anxiety, and basically feelings of hopelessness and despair,” she said taking time to let this sink.
This condition, Riziki noted could have manifested itself way back in 1996 when her parents separated leaving her mother as the sole provider. She was only five years old, she recalled.
“Prior to that there was a lot of tension and animosity in the house, and even after that we suffered a lot. We basically just moved from the suburbs to the outskirts of Nairobi,” she said.
For any person, this was a total shift in social and economic status.
“When we were staying with dad we were financially stable but when they separated, it left us struggling because our mum had huge loans to clear. The first day, we slept in the car and then from there on, we put up in one relative’s house after another,” she added.
From there on she grew up with a lot of resentment and some bitterness.
Riziki became withdrawn and slowly sunk into loneliness and even toyed with the idea of suicide at some point.
Fast forward, Riziki, a mass communication student with one year left to complete university education, she got into bad company. She imbibed alcohol regularly and jumped from one relationship to another.
In 2017, while working in an events management firm, she became pregnant and lost her job. This only added to her miserable state.
“Depression was like a wound expanding in me. I couldn’t sort out my challenges as small as they appeared. So many wrong things happened to me. I could even go to bed with a man after a night of drinking, and the following day, it would make me feel so bad. I fell in love with a man who had promised to wed me, but it also failed,” she said.
She even started being violent and did not know how to deal with it. When she got her baby in 2017, she became keener on cleanliness, and it could disturb her to see a spot of dirt in the house.
Mental health experts also describe the ADHD condition and people who suffer from it as having trouble focusing attention on a single task or sitting still for long periods of time.
But Divina James Kabalo, a psychosocial expert, said that such people require psychosocial support, which contributes to the prevention of mental health challenges and provides healing and support to those living with the condition.
“Mental health, like physical health, is important at every stage of life, from childhood and adolescence through adulthood and old age. Psychosocial and mental health wellbeing motivates the development of life skills which enables individuals, families, or communities to understand and engage with their environment, and make healthy choices which lead to hope for the future,” she noted.
Kabalo said that people who are mentally healthy, impact society positively and increases their productivity, improve economically, and their relationships.
She said it is important that mental health issues are taken seriously as they are important not only for individuals, families, and communities but also for the society at large.
“People are suffering from mental health in our communities and are not aware that they can be helped. On the other hand, lack of awareness, adequate personnel in mental health, finance and infrastructures, stigma, and discrimination make it difficult to access the services,” she said.
She said that the government should invest in mental health at all levels, from families and communities to the national levels.
“Mainstreaming psychosocial support into mental health at those levels will have a great contribution to prevention, healing, and continuous support to the affected,” she noted.
But to demonstrate that she is overcoming, Riziki sat through the one hour interview, calmly and didn’t show any sign of boredom.
“As a person steadily overcoming my condition, I want to advise anybody who cares to listen to know that the mental health disorder does not announce itself, but can look out for any abnormal conditions such as what I have shared,” said Riziki, a born-again Christian who draws inspiration from evangelist T.D. Jakes’ teachings.
However, she attributed her recovery to the psychosocial support and therapy she received from Dr. Catherine Syengo, a psychiatrist at the Ministry of Health.
She has taken me through every step in my recovery since I started therapy last year,” she added.
Asked on what people need to do to avoid the progression of mental health disorders, Dr. Syengo said that early detection and early treatment give best results.
She reckoned that building resilience; life skills, social skills and decision-making skills provided early in life, can go a long way in preventing some mental health conditions.
“Some of the abnormal signs one should be keen to notice include changes in how one feels, for instance, a sudden onrush of sadness, hopelessness and delusions," she said.
However, she lamented that there is no comprehensive data to facilitate tangible interventions. Local studies have shown a prevalence rate of about 11 percent.
Dr. Syengo said Universal Health Coverage (UHC) can provide mental health care.
“Indeed allocating at least Sh250 per capita per annum can provide basic mental health services; social support including family support is very key in managing mental health problems as well,” she noted.
She said to tackle the problem of mental health in Kenya, relevant bodies should replicate the National Task Force on Mental Health’s report recommendations.
The world marks the Global Mental Health Day on October 10, annually. This year's theme is "Mental Health For All."
Kenya inaugurated the mental health task force on December 11, 2019, which comprised of a multi sectoral team from the Ministry of Health and other agencies under the leadership of Dr. Frank Njenga.
Its key findings showed that Kenya has a high burden of mental illness due to ill health, psychosocial disability, and premature mortality with huge gaps in access to care. The report was launched on Tuesday, July 7, 2020.