One in four health workers is 'depressed', study shows

One in every four healthcare professionals exhibits signs of depression, a study by a leading hospital has shown.

The study by the Aga Khan University Hospital done in all the 47 counties, mainly in busy hospitals, also revealed that two in every five healthcare workers shows symptoms of post-traumatic stress disorder.

The study named “Protecting the well-being and strengthening the resilience of front-line health workers” interviewed nearly 4,000 (1,907 nurses and 2027 community health volunteers), and midwives between January and June .

The research project, which sought to highlight the state of mental health and resilience of front-line health workers in Kenya, revealed the burden among nurses, midwives, and the community. It focused on four areas; depression, anxiety, stress and post-traumatic stress disorder.

Out of the 1,907 nurses that were interviewed, 85 per cent had stress, with 40 per cent having post-traumatic disorder, 23 per cent exhibited depression symptoms and 17 per cent reported anxiety.

From the data, 72 per cent of the nurses had attained a diploma in nursing, 68 per cent had less than 10 years of experience and 54 per cent of them were working in public health facilities.

The figures were less similar to those of the community health volunteers with 25 per cent depressed, 85 per cent stressed, 38 per cent with post-traumatic stress disorder and 15 per cent anxious.

 “In most cases, you find issues like burnout being very common. You find that within your areas the population is high and you have many households to work with. So, you have to do a lot of work, you often get tired, and you are not given a stipend; When you ask, you are told you are a volunteer, and it demoralises you,”  said a volunteer in the study.

Another adds: “We have never received any support, even someone coming to teach us how to handle issues and listen to our problems. We leave home to work in far-flung areas, what bothers me, when I get home in the evening, my kids do not have something to eat.”

One of the nurse managers involved in the study said: “There is no privacy even when one has a problem, our issues are handled in the hospital. We need resource allocation in both facility and money.”

Last week, a psychiatrist nurse, Magdalene Wamatu Kiboi attached to Gatundu Level 5 hospital in Kiambu County was found dead.

She hanged herself inside her house in Gatundu town. In a suicide note, she claimed that evil spirits had pushed her to commit suicide.

She was a champion of mental health and it is not known what prompted her to commit suicide. Investigations are ongoing.

Some of the key drivers for mental health challenges that were identified in the study included heavy workload, lack of resources, poor work environment, irregular salary payments among nurses and midwives and lack of salaries for CHVs.

Though mental disorders are common and widespread, a majority of Kenyans who suffer from these illnesses do not get the care and treatment they need. A Kenya National Commission on Human Rights (KNCHR) audit of the mental health system in Kenya estimates that out of six people with mental illness, five do not receive any treatment.

“There is a high prevalence of mental disorders among formal health workers (nurses) and CHVs. This, despite differences between these cadres, such as education and income levels,” said Prof Amina Abubakar, the Director of the Institute for Human Development,  AKU.

The study also noted that health workers are not trained to care for their own mental health. Most guidelines outline how health workers should handle clients’ mental health needs, save for the one addressing health workers’ mental health released during the Covid-19 pandemic.

“In our analysis of policy documents, we learnt that there are various policies that touch on mental health. However, these policies are mainly focused on the patient, with limited focus on the health workers from whom we expect high-quality health care,” she said.

Therefore, she said, there is need to address the key risk factors associated with these mental disorders for health workers and invest in psychosocial support programmes for front-line healthcare workers.

This will empower them to enjoy their own right to mental well-being, which is critical for them to ensure continuity of quality health care services provision and the achievement of universal health coverage.

Further, the study identified the need to train mental health practitioners who can then be deployed in the health system to provide mental support as needed.

“We also need to establish structures including policies –that promote the well-being of health workers who are crucial in achieving Universal Health Coverage,” said Dr Eunice Ndirangu-Mugo, Dean, School of Nursing and Midwifery, East Africa, AKU.

President Uhuru Kenyatta recently signed into law the Mental Health Bill, which seeks to protect the rights of Kenyans with mental disorders,

The Kenya Mental Health Policy says that up to 25 per cent of out-patients and 40 per cent of in-patients have a mental condition but laments inadequate data and information on mental health, neurological and substance use prevalence.

The study was sponsored by Johnson and Johnson Center for Health Worker Innovation.

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