The prevalence of mental disorders in adults in different level general medical facilities in Kenya: a cross-sectional study

Abstract

BackgroundThe possibility that a significant proportion of the patients attending a general health facility may have a mental disorder means that psychiatric conditions must be recognised and managed appropriately. This study sought to determine the prevalence of common psychiatric disorders in adult (aged 18 years and over) inpatients and outpatients seen in public, private and faith-based general hospitals, health centres and specialised clinics and units of general hospitals.MethodsThis was a descriptive cross-sectional study conducted in 10 health facilities. All the patients in psychiatric wards and clinics were excluded. Stratified and systematic sampling methods were used. Informed consent was obtained from all study participants. Data were collected over a 4-week period in November 2005 using various psychiatric instruments for adults. Descriptive statistics were generated using SPSS V. 11.5.ResultsA total of 2,770 male and female inpatients and outpatients participated in the study. In all, 42% of the subjects had symptoms of mild and severe depression. Only 114 (4.1%) subjects had a file or working diagnosis of a psychiatric condition, which included bipolar mood disorder, schizophrenia, psychosis and depression.ConclusionThe 4.1% clinician detection rate for mental disorders means that most psychiatric disorders in general medical facilities remain undiagnosed and thus, unmanaged. This calls for improved diagnostic practices in general medical facilities in Kenya and in other similar countries.

Knowledge, attitude and practice (KAP) of mental illness among staff in general medical facilities in Kenya: practice and policy implications

“…In this context therefore, health workers are strongly motivated as they use the acquired knowledge and skills imparted during training (CME) in mental health to provide interventions that profoundly improve the effectiveness of their medical care services. There is a high prevalence of mental disorders (and in particular depression) found in the general facilities which go undiagnosed 23 , specifically where there is lack of adequate numbers of psychiatrists. 26 This calls for integration of mental health training and service provision into primary health care services (training nurses in mental health services during their induction years in training) such that interventions that profoundly improve the effectiveness of medical care services can be provided.…”

“…In recognition of the need to serve its people in their communities as well as the need for early intervention and follow-up services, the government of Kenya instituted different health care facility levels and the kind of staff to be deployed. 23 The health facilities representing the above spectrum were selected for this survey on the basis of their proximity (within a 200 kilometre radius) to Nairobi, the capital city of Kenya. Data was collected by interviewing medical personnel in the selected general medical facilities using an in-depth 76 item structured questionnaire adapted from Mayou and Smith.…”

Traditional healers and provision of mental health services in cosmopolitan informal settlements in Nairobi, Kenya

“…However, the most plausible explanation is that they did not have the appropriate knowledge on how to diagnose those conditions; a familiar story amongst general doctors in general hospital facilities. 16 It is noted from the in-depth interviews that some patients who consulted traditional healers had at one time consulted the health centres but were not satisfied and hence sought services from the traditional healers. The same was found by Ovuga in Uganda.…”

Epidemiological Patterns of Anxiety Disorders in Kenya

“…The number of rape cases reported in Nairobi women's gender recovery centre was 341 which was a quarter of the one thousand women rapes reported in the country [27]. Anxiety disorders seen in general health facilities are more frequently associated with chronic medical conditions [28]. Using the Leeds Scale for the Self-Assessment for Anxiety and Depression (LSAD) in this study, 20 to 30% of patients who had cancer, HIV, diabetes and cardiovascular disease had features of general anxiety disorder.…”

“…Most of these costs are quantifiable and occur outside the health sector; loss of employment and income generation, increased absenteeism from work or school, poor performance within the workplace or school work and premature retirement [5]. People with mental disorders have higher unemployment rates, less access to treatment and face more discrimination [6][7][8]. Anxiety is, "one of the main motivating factors in most of human behaviour" and is a normal reaction to threatening or unthreatening situations in the environment.…”