African Woman and Child Feature Service

A group of patients at Mathari Hospital have found themselves stuck at the facility for a total of 186 years after their families declined to accept them back even after they were found fit to be integrated in the society.

Two of the patients have been at the hospital for 26 years, another two have been there for 17 years, four have stayed there for 16 years, one for 10 years, another two for eight years and six years and three for four years.

For some of them, no family member has bothered to visit them or enquire from the hospital how they are doing for all this time. Others have stayed for too long that they have decided to make the hospital their home and take on new roles such gardening and growing vegetables or educating new patients on how to cope with life.

The hospital, which is the only place they are accepted for now, is sinking under the burden of having to sustain them on food and medication whenever they fall sick.

“This problem is having a negative impact on the operation of the hospital as we have to spend millions of shilling looking after them, yet we are operating on a huge deficit in our budget,” says Dr Nelly Kitazi, the head of the facility.

Majority of the 17 patients in question committed serious crimes ranging from murder to robbery with violence among other things while in a state of mental illness. There are those who killed their parents, children, relatives, animals or fellow community members.

In one case, the family is yet to reconcile with a man who killed his parents and used their blood as stew for Ugali. “We have not forgotten what he did and we shall deal with him,” the family told the probation officer when he asked what they thought about him over 15 years down the line. In another case, a man is said to have relished talking about how he killed his brother and then ate his liver. Many others who committed murder in a state of mental illness have similar stories to tell.

As result of such crimes, they were arrested and committed by the court to Mathari Hospital as Offenders of the Law with Mental Illness who needed to be treated. According to the law, these patients are expected to be held at the hospital for a three year period as they undergo treatment, after which their status is reviewed.

The hospital does a comprehensive assessment of their mental status using the nurses in the ward where the patient is held, a Psychiatrist, an Occupational therapist, and A probation officer. Each of these people writes a report about the patient’s mental status and character. The four reports are then presented to the board for approval before the person is released from the facility.

But if one of the four reports is negative, then such patient’s case is not even presented to the board and is considered not fit for discharge from the hospital. This is where the problem lies.

While these patients have been certified by the nurses, a psychiatrist, and occupational therapists reports as fit to be integrated back into their families and society, the fourth report- the probation officer’s reports has been negative.

For a patient to be released back to the community, a probation or social worker is send to talk to his family members and neighbours about their readiness to receive and stay with the person once he or she is discharged from the hospital.

Majority of the families have declined to accept such people, with some warning that they will kill them if they come back to their home. Such attitudes are the ones that makes probation officer write a negative report, which begs for the patient not be released for his or her own safety.

A case in point is a man who has been at the hospital for 26 years after killing a family member cannot go back home because his family has declined to accept him back. His wife, who continues to stay in their matrimonial home, has had three sons with another man. The son’s, who have been allocated part of the property, are hesitant to have who would be their step father released.

Meanwhile, the old man constantly speaks fondly of his trusted wife and cattle, which says he wants to tend once released from the hospital. His case has left the hospital in catch twenty-two situation. If they release him, he may turn violent on learning what the wife has done. Or he might be killed or injured by his family members who do not want him. This has forced probation officers to write negative reports on more than three occasions.

Other families decline to have the patient back arguing that justice has not been done by holding these offenders of the law with mental illness at Mathari hospital and not at Kamiti Maximum prisons or any other prisons where they can serve a stiffer sentence. Such families even believe some of these people feigned mental illness so as to be held at the facility.

It such negative attitudes are the ones which have forced the hospital to start a campaign for the construction of Halfway Houses to accommodate patients who have been approved as fit for reintegration back into the society.

“The hospital believes to address the current problem where patients are rejected by their families pushing the burden to us, there is need to start Halfway Houses to accommodate them first before they go to their families,” says Dr Kitazi.

The hospital is planning to speak to leading companies to offer job opportunities to these people while in these Houses.

Such houses are considered as a bridge between the hospital and the person’s family. While living in this house, the ex-patient is allowed to integrate within the society, giving his or her family time assess if indeed he or she has changed.

A probation officer monitors their behavior as they move between the house and their place of work, business or college. If the officer files positive reports, he or she is allowed to leave the house and join his family (see separate story here on the Halfway houses).

Being resident in these houses will offer them refugee from a hostile family environment. Indeed, such hostilities have forced some of those patients released from the hospital to troop back to the facility after a couple of weeks outside the facility. Those who have come back tell the nurses and fellow patients that they consider the hospital a safe and friendly home, where they are wanted. Others have been brought back to the facility by their families after a short stint with them.

“Some relatives love to have their people here than staying with them, which is becoming a major burden to us,” says Dr Kitazi.

However, there are patients who are stuck at the hospital even after completing the mandatory three years because the hospital or the board does not feel comfortable to release them. Dr Kitazi says some of them are likely to commit serious crimes if released and they are better off at the facility as they undergo treatment.

These actions by the hospital are informed by past experience. In one case, a woman who had killed his child, and then released after three years, was brought back to the hospital when she killed her second child. Other people have committed murder or other crimes immediately after the board approved their release from the facility.

Meanwhile, the prison department is blamed for worsening the burden of the hospital by abandoning patients at the hospital after they take them there for treatment and for not providing security at the facility.

On a number of occasions, some of the patients who are held there as prisoners with mental illness have jumped over the wall and disappeared into the bordering Mathare slums. There is no sight of policemen at the maximum security section of the hospital, where these patients with criminal records are held.

An AWC-Feature