Abstract
The degree to which the mental health services are utilized depends partly on the public’s views about mental illness and the public’s perceptions about the roles of the providers of the services. Therefore, effective implementation of Kenya’s mental health policy during the 1990s was likely to be influenced in some degree by how far it was compatible with the public’s concepts of mental illness. The aim of this study was thus to explore the conceptual model underlying the views of the Kenyan public about mental illness and relate it to the national mental health policy of 1994. A household survey was conducted using a Key Informant Interview schedule. Results showed that the public subscribed to a biopsychosocial view of mental illness and health care, which was indeed compatible with the mental health policy, which was rooted in the concepts of Primary Health Care, as articulated at Alma Ata. However, the public did not expect biopsychosocial care from the health services, but rather only the biological/pharmacological component, relying on other care providers for psychosocial management. This discrepancy could have impeded the implementation of the 1994 policy.
Similar content being viewed by others
References
Angermeyer MC, Breier P, Dietrich S, Kenzine D, Matschinger H (2005) Public attitudes towards psychiatric treatment. Soc Psychiatry Psychiatr Epidemiol 40:855–864
Bennett F, Maneno J (1986) (eds) National guidelines for the implementation of primary health care in Kenya. Ministry of Health, Nairobi
Bloch M (1991) Treatment of psychiatric patients in Tanzania: a survey of practices within the public health care system in the early phase of the Programme. Acta Psychiatr Scand 83:122–129
Bugais G, Rugeiyamu N (1991) Providing mental health services with Meagre resources in Tanzania. In: Okpaku S (ed) Mental health in Africa and the Americas today. Chrisolith Books, Nashville
Collins D, Quick JD, Musau SN, Kraushaar K, Hussin IM (1996) The fall and rise of cost-sharing in Kenya. The impact of phased implementation. Health Policy Plan 11(1):52–63
Dhadphale M, Ellison R, Griffin L (1983) The frequency of psychiatric disorders among patients attending semi-urban and rural general outpatient clinics in Kenya. Br J Psychiatry 142:379–383
Dhadphale M (1984) Psychiatric morbidity among patients attending the district hospital outpatient clinics in Kenya. M.D Thesis, University of Nairobi
Director of Medical Services, Ministry of Health, Kenya (1997) Telephone interview
Director of Mental Health, Ministry of Health, Kenya (2003) Telephone interview
Director of Mental Health, Ministry of Health, Kenya (1997) Telephone interview
Division of Mental Health, Ministry of Health, Kenya (1994) The first Kenya National Mental Health Programme of Action for the next ten years and beyond. Ministry of Health, Nairobi
Government of Kenya (1989) The Mental Health Act, 1989. Kenya Gazette Supplement no 90 (Acts No.7). The Government Printer, Nairobi
Harding TW, Climent CE, Diop M, Giel R, Ibrahim HH, Murthy RS, Suleiman MA, Wig NN (1983) The WHO collaborative study on strategies for extending mental health care, 11: the development of new research methods. AM J Psychiatry 140(11):1474–1480
Ilechukwu S (1993) Nigeria. In: Kemp D (ed) International handbook on mental health policy. Greenwood Press, Westport
Jegede R (1981) A study of the role of socio-cultural factors in the treatment of mental illness in Nigeria. Soc Sci Med 15a: 49–54
Jorm AF, MacKinnon A, Christensen H, Griffiths KM (2005) Structure of beliefs about the helpfulness of interventions for depression and schizophrenia—results from a national survey of the Australian public. Soc Psychiatry Psychiatr Epidemiol 40:877–883
Kempinski R (1991) Mental health and primary health care in Tanzania: an epidemiological survey of the use of primary health services. Acta Psychiatr Scand 364(83):112–121
Kimani V (1981) The unsystematic alternative: towards plural health care among the Kikuyu of central Kenya. Soc Sci Med 15b:333–340
Lauber C, Nordt C, Rossler W (2005) Recommendations of mental health professionals and the general population on how to treat mental disorders. Soc Psychiatry Psychiatric Epidemiol 40:835–843
Ministry of Health Kenya (2006) Second national health sector strategic plan. Ministry of Health, Nairobi
Ministry of Health, Kenya (1994) Kenya’s Health Policy Framework: implementation and action plans. Ministry of Health, Nairobi
Muga F, Jenkins R (2008a) Health care models guiding mental health policy in Kenya 1965–1997 (submitted to SPPE)
Muga F, Jenkins R (2008b) Training, attitudes and practice of district health workers in Kenya. SPPE (in press)
Muga F (1990) Psychiatric Morbidity in rural women in polygamous and monogamous marriages: a comparative study. M.Med Thesis, University of Nairobi
Mwabu G, Mwanzia J, Limambila W (1995) User charges in government health facilities in Kenya: effect on attendance and revenue. Health Policy Plan 19(2):164–170
Ozmen E, Ogel K, Aker T, Sagduyu A, Tamar D, Boratav C (2005) Public opinions and beliefs about the treatment of depression in urban Turkey. SPPE 40:869–876
Parsons T (1975) The sick role and the role of the physician reconsidered. MMFQ/Health Soc 53:257–278
Parsons T (1951) The social system. Routledge and Kegan Paul, London
Ramana R, Saxena S (1991) India: quality and access are the priorities. In: Appleby L, Araya R (eds) Mental health services in the global village. Gaskell, London
Riedel-Heller SG, Matschinger H, Angermeyer MC (2005) Mental disorders who and what might help? Help seeking and treatment preferences of the lay public. SPPE 40:167–174
Saravanan B, Jacob KS, Johnson S, Prince M, Bhugra D, David AS (2007a) Belief models in first episode schizophrenia in South India. SPPE 42:446–451
Saravanan B, Jacob KS, Deepak MG, Prince M, David AS, Bhugra D (2007b) Perceptions about psychosis and psychiatric services: a qualitative study from Vellore, India. SPPE. Dec 15 Epub
Schulsinger F, Jablensky A (1991) The national mental health programme in the United Republic of Tanzania: a report from WHO and DANIDA. Acta Psychiatr Scand Suppl 364(83):1–132
Sharma I (1993) India. In: Kemp D (ed) International handbook on mental health policy. Greenwood Press, Westport
Siegler M, Osmond H (1974) Models of madness, models of medicine. Macmillan, New York
Wig NN, Suleiman MA, Routledge R, Murthy RS, Ladrido- Ignacio L, Ibrahim HH, Harding TW (1980) Community reactions to mental disorders. Acta Psychiatr Scand 61(2):111–126
World Health Organisation (1990) The introduction of a mental health component into primary health care. World Health Organization, Geneva
World Health Organization (1984) Mental health care in developing countries: a critical appraisal of research findings. Report of a WHO Study Group. Technical Report Series 698. WHO, Geneva
World Health Organization (1978) Primary Health Care: Report of the International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. WHO, Geneva
World Health Organization (1975) Organization of mental health services in developing countries: sixteenth report of the WHO Expert Committee on Mental Health. Technical Report Series No. 564. WHO, Geneva
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Muga, F.A., Jenkins, R. Public perceptions, explanatory models and service utilisation regarding mental illness and mental health care in Kenya. Soc Psychiat Epidemiol 43, 469–476 (2008). https://doi.org/10.1007/s00127-008-0334-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-008-0334-0