Please prioritise self-care

Daisy Okoti
Lukoye is a professor of psychiatry with extensive leadership, teaching, and academic research experience. He leads and participates in mental health research locally and globally. He is also a member of the WHO World Mental Health Surveys Consortium, a leading collaborative project in psychiatric epidemiology. 

What inspires you?
The desire to make a difference. I have always believed that one person can make a difference. So if I am in a group and I am that one person, so be it. 

What made you specialise in mental health?
After four years of medical school, I went to Indiana University School of Medicine in the US. I spent my last two weeks in neurosurgery, looking forward to seeing a brain being opened. I have always been fascinated by how the human brain works. The resident I was working with told me it would take me another ten years to be eligible to open a brain, but the programme director understood my desire – I did not want to be a surgeon, I just wanted to understand how the brain works and fix it when it isn’t working correctly. She gave me a book on psychiatry and the rest is history.

What’s your take on mental health awareness in Africa?
Globally, many do not know what mental health is about. It is not a Kenyan or African problem. Unfortunately, mental disorders happen on the inside and we only see the end product. People do not understand things they don't see so it is difficult to explain this issue in a language that the public will understand quickly. Locally, believe we reached tipping point in understanding mental health when the President declared that there is a crisis in mental health. When political leaders start talking about mental health, we are making progress because it is likely to seep into policy formulation and, hopefully, into the budget. 

What kind of policies could make mental health problems more salient in healthcare management?
We need to put more resources in promoting good mental health, and this should be driven by national and county governments. We need to spend money on early recognition and prevention of mental illness, and invest in treatment facilities and rehabilitation centres for those who have previously suffered mental illness.

What recommendations would you make to government and other institutions on how to handle Covid-19?
Covid-19 has brought to the fore many things, including economic policy failures, inequalities, and abuse. Covid-19 has come like soapy water, poured itself over society, and opened everything up for everyone to see. One of the biggest wounds on the skin of our republic is how we have neglected the mental health of our people. Countries that have robust mental health systems suffered less from the effects of the pandemic. When disaster strikes, a population with a good mental health system is better able to handle the shock.

You are a writer, researcher, doctor, administrator, and you sit on several boards. How do you manage all these roles? 
Good time management. I only engage in activities that I absolutely have to do. I manage expectations, relationships and resources because that is what I have been trusted to do. I also have to take care of myself. Every once in a while I step back and think about whether I am doing the right thing and whether I want to keep doing it.

What worries you about Kenya’s healthcare system?
That one day something will happen to me and I will not get the medical intervention I need. This happens every day to others. At some point, when we were thinking about partitioning this country, we thought health was perfect leverage. I am worried that we think a child with diarrhea in Wajir should get different treatment from a child with diarrhea in Nairobi because of the people they elect. It means we do not value human life. 

What will be different about the new school of medicine at Aga Khan University?
The way we train doctors. We have incorporated inter-professional education where medicine students take common courses with nursing students and therefore learn from each other and have a better understanding of the separate but indivisible roles they play. We have also incorporated social sciences in our programmes. Our students will learn about the history and geography of their location, the cultural context in which they find themselves, how people interact with each other, exposure to law, ethics, and philosophy, critical thinking, early research and clinical exposure. We also plan to assess students over time rather than getting them to sit and regurgitate what they have learnt. Those are the distinctive qualities I believe a new medical curriculum must incorporate. 

Do you mentor younger professionals in your field?
Mentorship is a core part of my life’s philosophy. If I do all I do and after I die there is no one to carry my work forward, I will have wasted my existence. I was mentored by Frank Njenga and Norman Sartorius and their input in my career was profound. I have a chain of mentees dating about 10 years ago. In 2019, I organised a leadership and professional skills training seminar and brought in world experts to speak to a group of 20 mentees. I sometimes get emails from postgraduate students seeking advice and I try and make time for them. 

What are you looking forward to in your career?
As I turn 45, I yearn for continued self-improvement, to make a greater impact on global mental health, to have a longer chain of mentees, and to conduct more research. I want to make myself, my family and the people I interact with happy.
 
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