Improving Mental Health Care in Kenya

Stuart Mannon, M.D., community psychiatrist, acted as preceptor for 2 Indiana University “triple board” residents, Amna Aziz M.D. and Corissa Dionisio M.D., during the month of February in Eldoret. 

We collaborated with faculty, residents and medical students from Moi University School of Medicine and faculty of the MHTR hospitals including the Psychiatric inpatient facility and residential rehabilitation facility for substance use disorders.  We were able to participate in inpatient rounds and outpatient clinics at these facilities.  Spoken mostly in Kiswahili, intermittent summaries of content were provided by the interviewing physician during the course of the patient interview, creating an opportunity for us to be involved in the evaluation and treatment process. 

Activities included observing ECT, attending resident journal club and grand rounds.  We spent time at the Rafiki clinic, an AMPATH facility dedicated to adolescents and teens affected by HIV.  Lectures by Mannon, Dionisio, Aziz were given on trauma informed medical treatment, stress reduction for staff, and aspects of Cognitive behavioral therapy, respectively.  Mannon gave lectures on suicide risk assessment and cognitive behavioral therapy for psychosis to both psychiatric residents and medical students, and medical psychology students.  Mannon and Aziz gave lectures to the child life staff at the children’s hospital about recognizing mental illness, teaching staff how to help parents advocate for their children, and specific strategies for managing symptoms like pain and anxiety for hospitalized children.

One of the highlights was accompanying AMPATH’s psychiatric nurse Lilian Rono on home visits and consultations at outpatient AMPATH clinics. We learned about Kenyan culture and living.  We also saw the need to expand psychiatric care in the community setting, and witnessed early stages of establishing the mental health component for the Chronic Disease initiative taking place.  We had the privilege of being in Eldoret while Dr Joe Mamlin was there, which is unforgettable.