MENTAL HEALTH
Dr. Edith Kwobah
(MBCh.B, MMED Psychiatry, UON)
HOD, MENTAL HEALTH, MTRH
25 April 2023
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Content of presentation
• Definitions
• Why it matters
• Brief overview of common mental disorders
• Coping mechanisms
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WHAT IS HEALTH?
• WHO- health is complete physical, social, emotional
well being and not merely the absence of disease.
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What is mental health
• Positive sense of well-being
• Belief in own worth and the dignity and worth of
others
• Ability to manage life and take risks.
• Ability to initiate, develop and sustain mutually
satisfying personal relationships
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BURDEN OF MENTAL HEALTH
 1 in 4 of patients seeking care in hospitals have a mental/
psychological issue ( WHO)
 10-20% of youth experience mental disorders
 Depression, anxiety, and behavioral disorders accounting for 75% of the total burden
 In Kenya, 56.3 % have one or more psychiatric disorders. The
most prevalent disorders are mood disorders (39.0 %), Anxiety
(31.3 %), and Somatoform (13.0 %) ( Ndetei et al 2013)
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Mental health Stigma
 Causal attribution and perceived stigma
 Social distancing and rejection from both the public and health care
workers.
 Negative labeling of the mentally.
 Affect health seeking behavior resulting in poor outcomes
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What are mental disorders?
• Disturbances in :
Perception,
 Beliefs,
 Thought processes
Mood
Personality
Symptoms are persistent, and out of context (deviation
from normal)
Affects social occupational functioning
What mental illness is Not!
Witchcraft
• Ghosts
• Demons
• Curse
• Stress
• Too much work
• It is not a sign of weakness
• Its an illness like any other.
•
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Types of mental disorders
• There are many types of mental disorders.
• We focus on :
Depression,
bipolar mood disorders,
 Anxiety,
psychosis,
Substance use disorders,
suicide.
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Affects10-20% of general population
 Low mood – persists for two weeks
 Loss of interest
 Hopelessness
 Poor concentration
 Excess guilt
 Low energy
 Suicidal ideations
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BIPOLAR MOOD DISORDERS
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Prevalence 1- 4% of gen population
• Elevated, expansive or irritable mood
• Reduced need for sleep,
• Pressure of speech ,
• Racing thoughts,
• Inflated self esteem, grandiosity,
• Increased goal directed activities,
• Excess involvement in pleasurable
activities.
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PSYCHOTIC DISORDERS
• Include schizophrenia, brief psychotic disorder, psychotic
disorder due to medical condition etc..
• Prevalence = 1% in the general population
• Symptoms:
Delusions- False fixed beliefs
Hallucinations- Perception without stimuli
Disorganized thinking, behavior….
Avolition
Diminished emotional expression
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Alcohol and drug use
• 10-16% of the general population
• Now recognized as a chronic and recurring brain disease.
• Chemical changes in the brain makes stopping difficult.
• Moves from impulsive to compulsive use.
• Alcohol commonest substance of abuse.
• Others: Cannabis, Opiods, Cocaine, Khat. Nicotine…
• Stigma for those affected hinders treatment
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Anxiety disorders
• Commonest 20-30% of gen population
• Excess worry that interferes with social occupational
functioning.
Generalized anxiety disorder
Specific Phobias- Snakes, Heights…
Agoraphobia- Fear of situations where escape is difficult eg
lifts, supermarkets, matatus..
Social anxiety disorder- Fear of being judged, perfomance…
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Post traumatic stress disorder
• Follows exposure to life threatening events
• Re- experiencing
• Avoidance
• Being over vigilant,
• easily startled,
• poor sleep,
• irritability,
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Other Types of mental disorders
• Derilium
• Dementia
• Trauma – PTSD, ASD
• Sleep
• Sexual
• Eating
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• OCD and related disorders
• Neurodevelopmental disorders
• Personality disorders
• Impulsive disorders
• ……..and many others
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SUICIDE
• Top ten cause of death world wide
• 1 person every 40 minutes in the world
• > 90% have a mental illness
• Depression and substance use disorders common risk
factors.
• Other risk factors- Male gender, chronic illness, broken
marriages, living alone, job loss, failure …
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Causes of mental illness
• Psycho- Social
• Stressors
• Life events e.g bereavement,
unemployment
• Chronic adversity e.g poverty,
domestic violence
• Lack of social supports
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• Physical/ Biological
• Genetic
• Endocrine diseases
• Nutrition
• Infections- Hiv, meningitis…
• Medication- steroids..
• Trauma
• Substance abuse
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Current issues
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Treatment for Mental illness
• Bio- Medication
•PSYCHO -Psychotherapy
• Social -Altering social circumstances/
environment
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STRESS Vs Mental Illness
• Stress : "demands exceed the personal
and social resources the individual is able to
mobilize.
• Stress= applied pressure== force/ area
• Strain=stretch/unit length
• Hooks law- stress is directly proportion to strain
up to elastic limit.
• Weight increase beyond elastic limit result in a
break.
• Positive and negative events can cause stress
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COPING
COPING is an attempt to manage stressful demands.
Coping may be adaptive or maladaptive.
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Self care
Start simple
• Eat a well-balanced diet
• Exercise on a regular basis
• Sleep well
• Taking brief rest periods during the day to relax
• Avoid use of caffeine and other stimulants
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SELF AWARENESS
• Know what you are feeling at any given time, and why.
• Understand the links between, emotions thoughts and actions.
• Have personal values.
Self awareness is vital for your interactions as well as your personal
health
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SOCIAL SUPPORT
• We all need someone to lean on.
• Few but trusted friends
• Those who allow you to be you
• Those who give you positive energy
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Problem solving
• Identify the problem
• Endeavour to fully understand the problem
• Decide to tackle the issue - commitment
• Research/ explore all the available options and
resources
• Take actions to achieve to solve the problem
• Evaluate results…
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Anger Management
Bottled and or poorly expressed anger is an enemy of well
being.
• Express your anger when calm
• Take time out
• Relaxation – breathing in and out
• Use of I statement
• Seek PROFESSIONAL help
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POSITIVE THINKING
• Your thinking determines your feeling and your
behavior.
• You need to identify your negative thinking and
replace it with healthier thinking.
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Behavioral activation
List some activities you enjoy
List some responsibilities you need to take care of.
Try doing at least one activity or responsibility each day.
Recognize pleasant feelings, and sense of achievement after
doing the activity or responsibility.
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When it is too much…
Seek help
Counsellors
Psychologists
Psychiatrists
Remote Services
Huduma Centre Hotline-0206900030
Redcross-1199
LVCT- 1190
Befrienders Kenya- 254722178177
Conclusion
• There is no health without mental health ( WHO)
• Anyone can suffer mental illness
• Stigma is a major hindrance to
Seeking help.
• Be concerned about your mental
wellness and that of your neighbor.

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Help is available
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Acknowledgements
We wish to acknowledge;
• Astellas Global Health Foundation for funding this program
• Moi Teaching and Referral Hospital for supporting implementation of
mental health services .
• Academic Model Providing access to care for hosting the program.
• Dr Matthew Turissini, Dr Edith Kwobah and team for offering their
expertise in the care for the general public and leading the
implementation of interventions.
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eckamaru@gmail.com
0721763412
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