Patient’s Digging Deep to Access Mental Health Services
- A weekly one-hour session costs Ksh.3000/=, sessions last a lifetime
- NHIF and insurance don’t pay for out-patient services
For many who have had the privilege of attending a basic economics or business course, one of the first concepts taught is the difference between a need and a want.
A want is something you desire but don’t need while a need is something you cannot live without.
Where does mental health treatment fall?
Calculating what it costs her monthly to access mental health treatment, Akinyi Awora will tell you it feels more like a want than a need.
Though she was diagnosed in December 2018, Akinyi has been on treatment for one month and has had to dig deep into her pockets.
‘I thought it would be a bit costly but I didn’t anticipate just how much,’ she says.
Suffering from Clinical depression, Akinyi will have to be on treatment for life. At the moment she doesn’t know if she will be able to on with the treatment for even a year.
Breaking down the numbers for me, Akinyi currently sees a psychologist twice a week at a cost of Ksh. 3000/= per session, which lasts an hour.
She is also on medication, taking Prozac twice a day at a cost of Ksh. 1410/= a pack. An antidepressant, Prozac comes in a bottle of 30 pills. She needs 2 bottles a month to complete her monthly dose.
In total, Akinyi would have to fork out Ksh. 26,840/= each month to keep up with the treatments, none of which are paid by her health insurance.
The World Health Organization (WHO) reckons that 20% of mentally ill persons are not able to access treatment because of barriers such as cost and availability of mental health professionals.
Kenya has 62 psychiatrists and 500 psychiatric nurses for a population of 47 million people. If the personnel are already scarce and we factor in the high cost of accessing these personnel, aren’t we basically denying mentally ill patients the care they deserve?
A 2018 performance report by the National Hospital Insurance Fund (NHIF) said that they had registered over 7.6 million principal members, with 25 million Kenyans registered so far.
NHIF at the moment only caters to in-patient mental health services yet the bulk of mental health treatment is out-patient services.
Linet Odidi, a counseling psychologist in Kisumu agrees that the cost of mental health treatment is unattainable for most patients.
“As NHIF does not pay for outpatient services, so do most other private insurance companies,” says Linet.
With all her patients paying for their sessions using cash, Linet admits that it can become difficult for patients to pay for their treatment, which would normally require multiple sessions.
Much like other health professionals, mental health practitioners are part of organizations that regulate their practice and ensure that they maintain certain ethical standards.
However, when it comes to the regulation of how much the professionals can charge for treatment services, there is no regulation.
The Ksh. 3000/= Akinyi pays for a therapy session is consultation fees. Some institutions and professionals have been known to charge up to Ksh. 7500/= for a single session.
“The burden of disease will reduce if we take a preventative approach, making mental health treatment affordable. If left untreated, mental illnesses have been shown to increase the overall disease burden in the world,” she explains.
A report published in October 2018 by the ‘Lancet Commission’- a group of 28 global mental health specialists, said that the burden of mental illness could cost the global economy $16 trillion by 2030
Seeing the struggle some of her patients go through in order to access treatment, Linet is currently in talks with a local insurance company to ensure that her patients can pay through insurance at the very least be able to file a claim.
“This is a minute step I am taking, hopefully, it will pay off. However, the government must continue working on providing accessible and affordable mental health services,” she concludes.
Although the government is currently testing the Universal Health Coverage (UHC) program in four pilot counties, one of them being Kisumu, it will be interesting to see whether mental health services will improve when the program is officially rolled out in 2022.