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| Families living with the mentally ill |
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| Written by Arthur Okwemba | |
             But findings of a recent study on the relationship between them and their families or relatives now shows that taking care of such patients leaves family members just as worse-off as the patient. First of its kind in Kenya, the study classifies mentally ill patients as one of those causing untold grief and immense losses to their families. Children are the most adversely affected when one of their parents is mentally ill, the study found. Families of these patients suffer serious economic effects, poor household interactions, and strained relationships with children. Those interviewed said caring for the mentally ill had affected their social life as well. A total of 175 relatives of mentally ill patients and 107 patients participated in the study, with 61.2 per cent of the respondents saying they lived with the patient in the same household. Most of the patients were young and better educated, who relied mainly on their parents or siblings for care. But having to take care of a mentally ill patient had various effects on the family or relative. Close to 63 per cent of the families interviewed said their work or employment had been affected; 56 per cent said relationship with children was bad; 43.5 per cent had a problem with social life; while 38 per cent were experiencing economical or financial problems. Others had either lost their jobs, forced to work partime or to constantly shield young children from violence, says the study titled Burden and Impacts of the Mentally Ill on their Relatives in Kenya- A Case of the Mathari Hospital. Twenty six (26) of those interviewed said their mentally sick patient, who also happened to be the sole bread-winner, had lost a job due to the illness, affecting the family’s survival. Yet, only 8 of the 168 relatives interviewed said such patients were receiving disability pension. But the situation was worse if the family member or relative was the one who lost a job due to the patient’s illness. Of the 175 relatives interviewed, 36 people said they had lost a job due to their relative’s illness; another 37 were forced to work part-time so to take care of him or her; with a similar number missing work as they provided this care. About 33 percent of the relatives said losing a job had severely affected the family’s welbeing; while over 16 per cent said their relative’s absence from work had harshly affected their families operation. Scientists affiliated to the Africa Mental Health Foundation (AMHF), who conducted the research, were for the first time studying the difficulties experienced by families living with the mentally ill. “The reason we decided to undertake this study was to provide scientific evidence on the problems faced by families who care for the mentally ill in resource poor settings like ours,” says Prof David Ndetei, the lead researcher and Director of AMHF. One of the problems, says Prof Ndetei who is also a lecturer at University of Nairobi, clinicians focus only on the patient and prescribed drugs, without any regards to the needs of their relatives. The researchers say caregivers of mental patients experience two types of burdens: subjective – psychological consequences such as anger, guilt, sorrow and stigma - and objective- disruption of routines in careers, financial difficulties, and physical violence, among others. They argue that problems facing families living with a mentally ill person have been multiplied after the government shifted emphasis from institutions to community-based care for these patients. Although in developed countries this approach has succeeded due to availability of facilities such as day care units, half-way houses or sheltered workshops; none or few these exist in developing countries like Kenya. Hence in an attempt to make the same work in Kenya, families shouldering this burden are forced to cope with negative economic and social effects ranging from mild to extremely severe. In addition to losing a job, another economic effect was the cost of treatment of the patient, with 30 percent of the 134 of who answered this question saying the patient’s treatment fee had severely affected their families incomes. Yet disquieting was responses from 36.4 per cent and 10 percent of the relatives who reported that their patients refused to take medicine sometimes and always, respectively. In about 38 per cent of the cases, force had to be used to make the patient take medicine. While 35.8 per cent usually sought help from other people to have the patient take the medicine. Another 12.2 per cent of the patients always refused to go hospital, actions family members (43.9 per cent) said it affected them a lot. Almost half of the families ( 48.7 per cent) interviewed were at pains as they explained how some of these patients added salt to injury by misusing alcohol, resulting in a lot of money being used to manage them. Other economic effects abound as families or relatives are made to meet expenses resulting from the actions of their patients. During the interviews, 175 relatives said they had to reimburse other people whose property had been damaged by their patients. Another 64 families had to repair their own property destroyed by the patient. To restrain such patients, 58 of the relatives had hired someone to help them do so. But some family members were helpless in this situations. An estimated 12 per cent did not know how to deal with those who destroyed properties. For others, placing the patient to stay at Mathari hospital as long as it takes, was the best intervention. Those whose patients were not in such institutions complained of having to persevere the pain of living in the same household with these patients. At least 48 per cent of the respondents said being disturbed at night by the mentally ill was rampant. Families also highlighted physical aggression and shouting at or abusing people as some of the problem they had to deal with. As a result of these actions, some patients were beaten by people who did not understand their condition. Of the relatives interviewed, 68 per cent said they either used force or sought help to contain such aggressive and violent patients. The sources of help they turned to whenever they experienced these problems were as varied as those who were interviewed. About 3 percent of the relatives consulted traditional healers, with a similar percentage seeking the help of faith healers. But 91.4 per cent sought help from health centres for they believed this was the appropriate place to handle the situation. The high number of people who took this action could be explained by the somewhat short distances they had to cover to get to the nearest health centre. Almost half of those interviewed said the nearest health facility was between 5 and 50 kilometres from their homes. Meeting the cost of transporting the patient to the health centre however remained one of the most agonizing things the relatives had to deal with. Interestingly, some of the family members who went through this still conducted traditional healers, believing they would compliment conventional treatment. Faced with this plethora of problems, the researchers now recommend for a holistic approach to the problem of mental illness to address the plight of the families living with the mentally ill as well as the patient. Providing group and family therapy for relatives and patients separately and together, psycho-education and improved coping skills, need to be pursued, the researchers propose. They also recommend the need to put into consideration the psychological and mental development of the patients children in order to try and prevent psychiatric morbidity in growing children. Psycho-educational interventions for families who have a mentally ill patient such as understanding the ill person, coping mechanisms, and improving communications, need to be tackled, the researchers further recommend. They also want stigma related to the illness to be reduced. Conducting cross-cultural studies to evaluate the consistency and variability of the burden of mental illness on families need to be considered as well. An AWC-Feature |
| Kenya Audio Visual Archives Conference |
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The African Woman and Child Feature Service, the Kenya Archival Study Group and the Ford Foundation office in Nairobi, Kenya will hold the Preservation, Conservation and Restoration of Audio Visual Media Conference. The conference will be held at the National Museums of Kenya in Nairobi, from December 3rd – 5th 2008. |
| AWC at the Highway Africa Awards |
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