Rising Mental Health Burden Undermines UHC Goals

Kenya's ambition for Universal Health Coverage (UHC) faces a significant hurdle: the inadequate provision and accessibility of counselling and psychological support services. While the government's UHC policy acknowledges the critical role of counselling psychology in addressing mental health, the reality on the ground reveals a severe scarcity of these essential services, coupled with persistent societal stigma and weak policy implementation.

Globally, mental health is recognised as a pressing yet often neglected health challenge. The World Health Organization (WHO) estimates that one in four people will experience a mental health condition in their lifetime. In Kenya, depression, anxiety, and substance abuse are widespread, particularly among young people. Government statistics indicate that at least one in every four Kenyans will experience a mental illness at some point in their lives.

Policy Frameworks and Implementation Gaps

Kenya has established policy frameworks to address mental health, including the Kenya Mental Health Policy 2015-2030 and the Mental Health (Amendment) Act of 2022. These documents aim to secure mental health system reforms, align services with the Constitution of Kenya 2010, and integrate mental health into the Kenya Essential Package for Health (KEPH).

However, implementation has been slow, with policy gaps and inconsistencies leaving counselling services poorly resourced. The UHC framework envisions integrating mental health into primary healthcare, offering early detection and person-centred care, but these services remain underrepresented. This has resulted in a limited number of trained counsellors and psychologists, often concentrated in urban areas, leaving rural populations underserved.

Societal Stigma and Resource Limitations

A major barrier to accessing mental healthcare in Kenya is the pervasive societal stigma. Many Kenyans view mental illness as a personal failing or a spiritual problem rather than a medical condition, discouraging individuals from seeking help. This stigma not only prevents people from admitting they need a counsellor but also isolates those living with mental health conditions.

Furthermore, mental health services in Kenya are severely underfunded, receiving less than 1% of the Ministry of Health's budget. This translates to an expenditure of approximately KSh 0.15 per capita, significantly lower than the global median of KSh 250 per capita. This chronic underfunding contributes to a shortfall in mental health professionals, inadequate infrastructure, and limited access to treatment.

Impact and Economic Costs

The consequences of neglecting mental health are far-reaching, contributing to high incidences of suicide, a preventable cause of death. In 2024, Kenya reportedly saw a 52% rise in suicides compared to 2017, though experts believe the actual numbers are higher due to underreporting and the criminalisation of attempted suicide. Untreated mental health conditions also impose a significant economic burden, with an estimated national cost of KSh 62.2 billion annually, roughly 0.6% of the Gross Domestic Product (GDP), primarily due to lost productivity.

Evidence and Data

• Prevalence: At least one in four Kenyans will experience a mental illness in their lifetime.
• Outpatient Cases: 20-25% of outpatients seeking primary healthcare services exhibit symptoms of mental illness.
• Budget Allocation: Mental health receives less than 1% of the national health budget.
• Treatment Gap: An estimated 75% of people with mental health conditions in Kenya remain untreated.
• Economic Cost: Untreated mental health conditions cost Kenya approximately KSh 62.2 billion annually in lost productivity.

Addressing the Gaps: What Next?

To effectively integrate mental health into UHC, policymakers at both national and county levels must prioritise counselling services as a core health offering, not an optional add-on. This requires increased resource allocation, training of more personnel, and embedding counselling into primary healthcare facilities.

The Social Health Authority (SHA), as the driver of UHC, should leverage digital infrastructure to expand access to counselling through telehealth platforms, helplines, and community-based outreach, particularly benefiting rural populations. Employers also have a role in establishing employee assistance programmes to address workplace mental health stress.

While the government integrated mental health services into the national insurance benefits package under the Taifa Care Model and SHA in 2025, anchoring mental healthcare within UHC, the challenge lies in ensuring equitable access and comprehensive coverage. The decentralisation of mental health services through Community Health Promoters (CHPs) is a positive step towards early, person-centred support.

What to Watch

The effectiveness of the integrated mental health services under the Social Health Authority and the reach of community-based mental health initiatives will be crucial to observe. Continued advocacy for increased budgetary allocation and sustained efforts to combat stigma are essential for Kenya to achieve its UHC dream, ensuring that mental health is truly valued and accessible to all citizens.