Assessment of the Need, Demand, and Access to Mental Health Care Services by Nursing Staff in Dispensaries Within Mombasa County, Kenya
Abstract:
Mental health and well-being are crucial for a fulfilling
life. Work related stress negatively impacts health care providers'
professionalism, quality of care delivery, efficiency, and overall quality of
life. It is important to identify and mitigate these work-related risk factors
to protect the mental health well-being of healthcare workers. The aim of this
study was to assess the provision, demand and awareness of need for mental
health care services amongst nursing care staff stationed in dispensaries within
Mombasa County, Kenya. This is a cross-sectional study that targeted nurses at
the dispensary level, facility in-charges, and County health personnel.
Quantitative data was collected using GAD-7 to measure anxiety, PHQ 9 to
measure depression and PCL 5 to measure PTSD. Qualitative data was collected
through IDI and key informant interviews with the facility in charges and the Sub-County
County nurse officials. Quantitative data was analyzed descriptively while
qualitative data was analyzed following Creswell six steps. The research
discovered the proportion of nurses in Mombasa County affected by PTSD severe
anxiety and severe depression as 12.6%, 22.6% and 3.2% respectively. These
conditions have their origin in work and personal matters with work-related
matters being the main contributors. Fear of stigmatization from colleagues and
the community negatively affected care seeking behavior. Nine county facilities
offered mental health services although understaffed with only 9 specialized
staff. The county has made some investment in mental health service provision,
this investment is however focused on service provision to the general public
as opposed to health care workers.
References:
[1] Adam Felman, and Rachel Ann Tee-Melegrito., 2022, What is
mental health. Medical News Today. https://www.medicalnewstoday.com/articles/154543
[2] WHO, W. H. O., 2021, Mental Health ATLAS 2020. https://www.who.int/publications/i/item/9789240036703
[3] Kenya Mental Health Action
Plan 2021 – 2025
[4] Maddock, A., Blair, C.,
Ean, N., and Best, P., 2021, Psychological and social interventions for mental
health issues and disorders in Southeast Asia: a systematic review. International Journal Of Mental Health
Systems, 15(1), 56.
[5] World Health Organization,
2015, Poor mental health, an obstacle
to development in Latin America
[6] Saloni, D., Hannah, R.,
and Max, R., 2021, Mental Health. https://ourworldindata.org/mental-health
[7] WHO., 2022b, WHO Fact Sheet.Disorders. https://www.who.int/news-room/fact-sheets/detail/mental-disorders
[8] WHO, 2022a, Constitution. https://www.who.int/about/governance/constitution
[9] OASH, 2020, Healthy People
2020, health.gov
[10] UNDP., 2022, What are the SDGs? | The Sustainable
Development Goals. https://shop.undp.org/pages/what-are-the-sdgs-the-sustainable-development-goals
[11] Marangu, E., Mansouri, F.,
Sands, N., Ndetei, D., Muriithi, P., Wynter, K., and Rawson, H. (2021).
Assessing mental health literacy of primary health care workers in Kenya: a
cross-sectional survey. Int J Ment Health
Syst, 15(1), 55. https://doi.org/10.1186/s13033-021-00481-z
[12] Mwangi C., 2013, Accessibility
to the Kenyan health care system Barriers to accessing proper health care,
Helsinki, Arcada University of Applied Sciences Nursing.
[13] KIPPRA., 2021, Strengthening Labour Relations to Avert
Strikes in the Health Care Sector in Kenya. https://kippra.or.ke/strengthening-labour-relations-to-avert-strikes-in-the-health-care-sector-in-kenya/
[14] Dworkin, 2012, Sample Size
Policy for Qualitative Studies Using In-Depth Interviews Editorial Published: Springer
Link, 12 September 2012 Volume 41, pages 1319–1320, (2012)
[15] Sokratis, D., Micol, A.,
John, A. O., and Kamaldeep, B, 2017, Assessing explanatory models and health
beliefs: an essential but overlooked competency for clinicians. BJPsych Advances, 23, 106–114. https://doi.org/10.1192/apt.bp.114.013680
[16] Smitha, B., 2020, Causes of Mental Illness. https://www.webmd.com/mental-health/mental-health-causes-mental-illness
[17] Keverne, J., and Binder,
E. B., 2020, A Review of epigenetics in psychiatry: focus on environmental risk
factors. Medizinische Genetik, 32(1), 57-64.
[18] Devokta, 2021, Factors
affecting utilization of mental health services from Primary Health Care (PHC)
facilities of western hilly district of Nepal. Published online 2021 Apr 30.
doi: 10.1371/journal.pone.0250694
[19] Mark, T., andCrick, L., 2012,
Why Does Mental Health Not Get the Attention It Deserves? An Application of the
Shiffman and Smith Framework. PLoS
Medicine, 9. https://doi.org/10.1371/journal.pmed.1001178
[20] Khanal, P., Devkota, N.,
Dahal, M., Paudel, K., and Joshi, D., 2020, Mental health impacts among health
workers during COVID-19 in a low resource setting: a cross-sectional survey
from Nepal. Global Health, 16(1), 89. https://doi.org/10.1186/s12992-020-00621-z
[21] Jumah, F. R., andDossani,
R. H., 2023, Neuroanatomy, Cingulate Cortex. In StatPearls. StatPearls Publishing Copyright © 2023,
StatPearls Publishing LLC.
[22] Kenya Mental Health Policy
2015-2030
[23] Maulik, P. K., 2017,
Workplace stress: A neglected aspect of mental health wellbeing. Indian J Med Res, 146(4), 441-444. https://doi.org/10.4103/ijmr.IJMR_1298_17
[24] Greene, M. C., Yangchen,
T., Lehner, T., Sullivan, P. F., Pato, C. N., McIntosh, A., Walters, J.,
Gouveia, L. C., Msefula, C. L., Fumo, W., Sheikh, T. L., Stockton, M. A.,
Wainberg, M. L., and Weissman, M. M., 2021, The epidemiology of psychiatric
disorders in Africa: a scoping review. Lancet
Psychiatry, 8(8), 717-731. https://doi.org/10.1016/s2215-0366(21)00009-2
[25] American Psychiatric
Association, 2013, Diagnostic and Statistical Manual of Mental Disorders,
5th edition
[26] Bandura, A., 2006, Toward
a Psychology of Human Agency. Perspect
Psychol Sci, 1(2), 164-180. https://doi.org/10.1111/j.1745-6916.2006.00011.x
[27] Dhira, T. A., Rahman, M.
A., Sarker, A. R., and Mehareen, J., 2021, Validity and reliability of the
Generalized Anxiety Disorder-7 (GAD-7) among university students of Bangladesh.
PLoS One, 16(12), e0261590. https://doi.org/10.1371/journal.pone.0261590
[28] Dworkin, 2012, Sample Size
Policy for Qualitative Studies Using In-Depth Interviews Editorial Published: Springer
Link, 12 September 2012 Volume 41, pages 1319–1320.
[29] Errazuriz, A.,
andCrisostomo, N., 2021, Prevalence of depression in Latin America and the
Caribbean: protocol for a systematic review and meta-analysis. JBI Evidence Synthesis, 19(1), 201-207.
[30] Grace Fernandez., 2021, The Intersection of Mental Health and
Chronic Disease. https://publichealth.jhu.edu/2021/the-intersection-of-mental-health-and-chronic-disease
[31] Hawkar et al , 2018, The
validity of Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) as
screening instrument with Kurdish and Arab displaced populations living in the
Kurdistan region of Iraq. BMC Psychiatry, Published online 2018 Aug 16. doi:
10.1186/s12888-018-1839-z
[32] Helbich, M., 2018, Mental
Health and Environmental Exposures: An Editorial. Int J Environ Res Public Health,
15(10). https://doi.org/10.3390/ijerph15102207
[33] Kumsta, R., 2019, The role
of epigenetics for understanding mental health difficulties and its
implications for psychotherapy research. Psychol
Psychother, 92(2), 190-207. https://doi.org/10.1111/papt.12227
[34] Kwobah et al, 2021, Mental
Disorders Among Health Care Workers at the Early Phase of COVID-19 Pandemic in
Kenya; Findings of an Online Descriptive Survey, PMID: 34366913 PMCID:
PMC8339368 DOI: 10.3389/fpsyt.2021.665611
[35] Lansana Gberie, 2017,
Mental illness: Invisible but devastating Superstitution often blamed for acute
mental health diseases Lansana GberieFrom Africa Renewal
[36] Maddock, A., Blair, C.,
Ean, N., and Best, P., 2021, Psychological and social interventions for mental
health issues and disorders in Southeast Asia: a systematic review. International Journal of Mental Health
Systems, 15(1), 56.
[37] Mendehall, et al,. (2017).
Nurses' perceptions of mental healthcare in primary-care settings in Kenya,
2018 Apr;13(4):442-455. doi: 10.1080/17441692.2016.1207196. Epub 2016 Jul 12.
[38] NACADA (2022). National
survey on the status of drugs and substance use in Kenya
[39] Nandikove & Ng’ambwa,
(2020). Community Perceptions on Mental Illness in Bungoma County, Kenya.
Journal of Dental and Medical Sciences 19(11), 45-52, November 2020IOSR
[40] Saia-Cereda, V. M.,
Cassoli, J. S., Martins-de-Souza, D., and Nascimento, J. M. (2017). Psychiatric
disorders biochemical pathways unraveled by human brain proteomics. Eur Arch Psychiatry Clin Neurosci, 267(1), 3-17.
https://doi.org/10.1007/s00406-016-0709-
