On the edge of the Ngong Hills, in a modest tin roofed building, Mary Wangaru Wahome is dreaming of a new standard of mental health service delivery for Kenya and the whole of Africa.
Mary is the founder and program manager of the Nairobi, Kenya based nonprofit organization, The Reason To Hope (TRTH). This community based mental health service takes a holistic approach to serving its clients across Kenya.
Earlier this week, I had the chance to sit down with Mary and some of the people helping to guide her mission.
In Their Own Words
The Reason To Hope (TRTH) envisions:
“A society in which mental wellness care meets the physical, emotional, social and spiritual needs of all people”.
To restore hope to individuals, families and communities, by empowering them with the information and skills for holistic social well-being.
Depression related illnesses directly cause poverty and vice-versa. Therefore, there is need to develop effective mental wellness care services as part of socio-economic development strategy.
In order to achieve the Sustainable Development Goals (SDGs), we require improving our mental health so as to achieve the full potential of our people, individually and the general population. For a sustainable mentally, healthy community, there must be after treatment care training and education programmes for the carers and users.
Research so far done in different parts of the world and in different communities both in developed and developing countries indicate that depression and stress related disorders are on the rise.
These behavioural disorders affect people irrespective of their sex, age, race, ethnicity, culture, religion, educational or socio-economic status.
The Reason to Hope: A New Approach to Mental Health in Africa
The Reason To Hope’ (TRTH) is a community based organization geared towards empowering the individuals, families, and communities to cope with the threat of modern day life issues which include maladjustment, peer pressure, stress, recreation and leisure, drugs and substance uses among others. We refer to the positive outcome as mental wellness.
Our programs are based on unique approach that has been evolved in the many years we have dealt with mental wellness under the umbrella of the Schizophrenia Foundation of Kenya.
The focus is never on the individual’s illness, but rather on the special importance of lives, the qualities, their affirmation, and then walking together from hope to hope.
From this enlightenment THE REASON TO HOPE program has continued to treat mental health issues with positive vision of MENTAL WELLNESS as we ascribe to the school of “Positive Psychology”.
The Reason To Hope is about more than education; it is about empowering the family and community members and friends of people with mental wellness challenges by providing self-help skills, awareness and support founded on the conviction that THERE IS HOPE of getting better, learning to help loved ones to get better. HOPE
“The capacity for hope is the most significant fact of life. It provides human beings with a sense of destination, and the energy to get started”
– Norman Cousins, American journalist.
The Light of TRTH
Susan suffered from a crippling depression. She found it nearly impossible to accomplish her activities of daily living due to the persistence of her symptoms and lack of adequate counseling or other services near her home in Nairobi.
In Kenya. across much of Africa, and indeed a vast majority of the world, mental illnesses are deeply stigmatized. Being a country with deep ties to the Christian church, mental illness is most often associated with demonic possession. Many, like Susan often find themselves pushed out of their communities, forced to live away from families, often with livestock or on the streets.
As she describes it:
“My depression seemed to have no end. It was by the grace of God that I was given an opportunity to speak at a local mental health conference after a medical doctor in Nairobi spoke with me one day. He realized the severity of my condition and felt compassion for the lack of options available.
He suggested I speak to share my story with the medical community. It turned out to be the best thing that could have ever happened to me. It forced me to prepare and thankfully my loving husband provided so much support to help me get ready for the big day.
By the time it arrived I had conducted a lot of research and was able to give a talk which received a lot of positive attention. After speaking a doctor from Greece asked if I would be willing to go speak to his students. I agreed and ended up going across Europe, Africa, and North America sharing my experiences about the lack of medical services in Kenya.
I found myself fighting back about a system that had in the beginning had not been so supportive of me. And then I found myself working to change it. That is why I am here today. That is why I am now a clinician with The Reason to Hope.”
Mugia came into contact with The Reason to Hope in a different way. Being a Communications student at Nairobi University who had experienced some difficulties during his teen years, he felt drawn to this program because he saw a real opportunity to give back to the community.
Now a digital marketer and public relations focused student, he is working on a documentary to help spread advocacy about mental health services to African youth with his fellow classmate Faith.
Faith and Mugia each see rising rates of adolescent, teen and young adult suicide in Kenya as a call to action and reason to push back against a system which has left so many without recourse due to mental illness and struggles with addiction.
In Kenya, the Ministry of Health does not officially pursue a mission related to providing mental services. Instead of counseling or other treatment methodologies, limited psychiatric treatments are the only options for people presenting in local health care settings with mental health concerns.
The matters can get even worse when those suffering try to seek out treatment from faith based services. Most Kenyan religious elders, whether from tribal communities such as the Maasai or Christian based ones, do not subscribe to the idea that mental illness is something which can or should be treated with therapy or holistic support.
Many fear telling their partners, families or employees about their symptoms out of fears of being ostracized, marginalized or targeted as victims. Mental illnesses and co occurring disorders often destroy families and wreak havoc on local communities.
This is not a problem isolated to Kenya or Africa. In this way, the challenges faced in these parts of the world reflect the service delivery challenges of many community mental health organizations around the world.
While some may be quick to presume that those in Kenya or Africa are in need of adopting the systemic approaches found in other parts of the world, I do not accept this to inherently be the case.
While the transfer of knowledge will always enrich therapeutic treatment modalities, I have seen enough about The Reason to Hope, to know that there is as much about their approach that could value other parts of the world, as the other way around.
In many ways, the holistic, community based approaches of TRTH are very much in line with the leading approaches of mental health practitioners such as those found at the University of Vermont Medical Facility in Burlington, Vermont where I completed my Masters of Social Work field training working as a social worker embedded within a child psychiatry department.
Kabona is a young preacher of the Gospel who is dedicated to making new choices about how he approaches mental health in his parish. He came to be a man of God after getting a friend hooked on drugs.
In his own words:
“It is true. I was called to be a preacher due to the immense guilt that I had for introducing my friend to substances which led him into a spiral of addiction for over two years. When I found about The Reason to Hope, I was interested to learn about what other resources I could use to help other people across Kenya who are addicted to drugs.
I absolutely believe that mental health services have a place in the church. Jesus was called to save the outcasts, the poor, the sick and the meager. These are the people who I want to reach. The Reason to Hope helps me to better lead my community by providing me with access to clinical experience that can change lives.
I have seen the results and I believe in this mission.”
Joseph came to be involved with The Reason to Hope from his connection to founder Mary and their shared careers as financial service providers. Today, he assists the organization in any way he possibly can offering everything from strategic financial management to rides for clients around the community.
“Jesus came to heal the sick. I believe I am doing God’s work by helping people to find to reach health and stability in their lives.”
Agu is a Masters level mental health clinician who came to work with The Reason to Hope to complete his studies. After his field placement and graduation he decided to stick around and help to train other mental health practitioners so that the organization could help to continue to add constellation sites to its program offerings.
Kenya has over 43 tribal communities living across its space. In many of these, unique languages, cultures and thoughts towards mental illness provide individual challenges towards delivering modern mental health services.
The Reason to Hope is spearheading efforts to create individualized programs that meet the needs of Kenya’s communities.
In addition to offering counseling services, activity programs, rehabilitation programs, developmental assistance, crisis support, nutritional training and other supports to individuals, families and groups; Mary’s organization is also leading advocacy efforts, publishing evidence based research, designing policy initiatives and working to ensure its work extends far beyond the borders of Kenya.
The Reason to Hope is a vital community resource and I am grateful to have been able to learn about its mission. The next step is ensuring that Mary has the resources she needs to continue her work.