By Samwel Doe Ouma June 7 2023

For long mental health has been hidden behind the curtain of stigma and discrimination despite one in every four individuals living with a mental health disorder, according to the World Health Organization (W.H.O).

The Taskforce on Mental Health report formed by President Kenyatta in 2019, reported that 25percent of individuals visiting outpatient health facilities and 40 percent of those receiving inpatient care have an undiagnosed mental illness, making the situation even more alarming than most would like to admit.

However, Chiromo Hospital Group- a group of psychiatric facilities with the only private sector level 5 hospital-offering promotive, preventive and curative mental healthcare- has initiated an approach that acknowledges mental illness patients’ unique challenges and equips them with the necessary tools, and has provided a safe and supportive environment that fosters open communication.

The initiative also raises awareness, encouraging health seeking behavior and understanding of mental health through educational initiatives.

According to Gathoni Mbugua- a clinical psychologist and head of digital relations at Chiromo Hospital group-through the initiative dubbed ‘Tufunguke’-Swahili word meaning ‘let’s open up’- the hospital strives to create an environment for individuals to share patients, caregivers and healthcare providers mental health experiences, feelings, access to resources and support for mental health care.

She adds that the nature of mental health challenges is such that it flourishes and exacerbates in silence and social isolation and Tufunguke’s objective is to help people to engage in preventive, promotive and curative mental health care.

“‘Tufunguke creates a safe space where people can talk openly and honestly about complex mental health topics. It can help alleviate stress and anxiety and provide a sense of belonging and acceptance,” she observed.

Ms. Gathoni says that the initiative takes different forms to reach masses through online conversation as well as physical engagements through events, training and workshops.

Through the hospital online platforms @ChiromoHospGrp Twitter handle, Facebook page Chiromo Hospital Group, Instagram chiromohospgrp and @chiromohospgrp Tik-Tok page, the hospital utilizes its digital spaces to increase reach and surpass regional barriers to form a social connection.

However, according to Gathoni, age, gender and class stratifications determine one’s position in the digital platform and that might restrict access.

She explains that the Tufunguke initiative with the use of digital platforms, shares important discussions and engaging topics that are mental health-related using unique hashtags that gain momentum quickly in the digital spaces.

The ‘Tufunguke’ Twitter strategy revolves around organizing tweet-chats every Monday known as #MindfulMondays and Twitter spaces every Wednesday.

She explains that tweet-chats – a time limited twitter conversation on a topic of choice- typically involves a panelist asking pre-prepared questions to a group of specialists.

During the tweet-chat, other online users are allowed to also answer the posted questions according to their understanding as well as ask follow-up questions.

The ultimate feature of a tweet-chat is a hashtag and one key indicator of success is being able to get the hashtag to trend. This means that it becomes visible to everyone who is on twitter and policy makers can take note and act on the discussion. Once in a while, a policy maker or government ministry twitter handle can be tagged to draw their attention to the topic of discussion.

She adds that “tweet-chat panel consists of Psychiatrists, Psychologists, Mental Health Researchers, persons with lived experience of mental illness and organizations in mental health advocacy.”

There are also daily posts on their Facebook and Instagram page, weekly Tik Tok and LinkedIn posts and over 20 plus YouTube videos on mental health.

Tufunguke social media campaign takes various approaches which includes Tufunguke testimonials where Chiromo hospital group clients share their stories either written, audio, or video format and having them published on the hospital social media pages.

As mental health issues continue to pose challenges, she says that, digital platforms have the potential to support communities to normalize vital conversations about mental well-being, thereby helping users forge mental and digital resilience.

The platform leverages the strength of online communities to host live sessions from mental health advocates, work with creator partners to launch videos that help end the stigma surrounding mental health and provide tutorials for digital well-being that users have access to.

To help in identifying immediate mental health needs that require urgent attention, Ms. Gathoni says that the initiative recommends to audience the globally accredited world health organization (WHO) mental health brief screeners (Embedded in the CHG, Website) to help individuals screen themselves and know their mental health status. These tools are free for all, confidential with instant results.

“If your mental health scores are not good, participants are subsequently advised to see mental health professional to confirm and advised to further seek a further evaluation for having a diagnosable mental health condition.”

Although Tufunguke is a Chiromo Hospital groups initiative it helps participants connect with other mental health providers who are not affiliated to the hospital to find reliable information and help while reducing the pressure on the health-care system.

She highlights that the platform provides a feedback option through direct messages (DMs) and comment sections of the platform which she described as “overwhelmingly positive,” which have become a place to connect, share stories, challenges and encourage others.

“The platform has in place mechanism for collecting participants feedback and response (through direct messages and comments sections) which has contributed towards more positive interactions as number of enquiries continue to rise each and every engagement.”

Some of the comments and direct messages come with enquiries which are followed through and where necessary help accorded.

Tufunguke aims at strategies to improve prevention, early identification, and treatment; expand provider capacity; and increase the integration of behavioral health and primary care.

Apart from the Tufunguke initiative, Chiromo Hospital Group operates a toll-free hotline (080022000) available 24/7, 365 days a year, and provides free, confidential emotional support, information, and referrals to any individual facing mental health challenges and their loved ones.

According to Ms. Gathoni Mbugua, the initiative has not only helped in creating awareness on mental health but also improved help seeking behavior and enhanced partnerships in the mental health care spectrum.
She adds that the online platform reaches an average of 100,000 people a month on social media.

One of the beneficiaries of the support system who is now a mental health advocate was referred to Chiromo hospital by a good Samaritan who took her to the facility when she had a manic episode. Janet Monda narrates her experience and how she has benefitted from the ‘tufunguke’ initiative.

In 2012 while studying at the University, Janet started experiencing changes in her life that would sometime inhibit her ability to function normally in daily life changing her from a normally calm girl to a totally different person.

Narrating her journey, Janet talks about her struggles before diagnosis, when she experienced distractions and didn’t take pleasure in day-to-day activities, she didn’t suspect that anything would be wrong with her, “Because I was in university and busy with class work and exams, I equated it to normal college pressure. However, these feelings persisted and at some point, I realized that something was wrong.”

I became hypomanic, started missing classes and was overconfident which was unusual considering that I had been a very quiet person.

“This prompted me to seek help at the college clinic where I was referred to a psychiatric who upon a psychological assessment recommended a clinical diagnosis.”

It was after this assessment that she was diagnosed with Bipolar Mood Disorder and hospitalized for one and a half month and upon discharge was advised to a break from classes and focus on healing through therapy and medication which she never did.
Janet explained her diagnosis to her mum who didn’t believe her and thought she was on drugs. When my Mum noticed that I was not my usual self she took me to Mbagathi hospital where the doctors there after an examination referred me to another public hospital mental hospital.

Once again, her symptoms reoccurred forcing her to be admitted at a public Mental hospital, where her experience was far from good.

“Instead of getting better, it was like my experience at the public hospital worsened my situation. I was admitted with patients whose conditions were severe than mine and worse still the healthcare workers at the facility would just read my file, prescribe drugs and there were no follow-ups at all.”

Despite accepting her condition this time round stigma and being labeled insane contributed to Janet defaulting on her medications, turning to risky self-sabotaging behaviors to cope.

“Despite of my challenges I was able to graduate from Moi University with a second honors upper division in banking and finance,” she said.

Around 2020 when COVID-19 was at its peak, she got into another depressive phase, this time however, her mother had known of her condition and was very supportive.

“One day my condition worsened yet again and I was found by a good Samaritan running and shouting along Ngong road,” she recalls.

Fortunately, the good Samaritan had heard about Chiromo hospital group through the ‘Tufunguke’ online interactions.

“She took me to Chiromo hospital group Bustani clinic where a psychiatric Dr Frank Njenga diagnosed me with the Bipolar mood syndrome again. This time round, I took my diagnosis seriously because it corroborated with the first diagnosis that I had been given in college several years back,” she narrated.

At Chiromo, the clinical team and staff treated her with compassion and understanding and explained in detail her diagnosis and what she was expected to do.

“Apart from the medications that I take, one of my therapies includes participating in the tufunguke platform which has helped Me with adherence to medication and provided a support system where we can openly discuss our unique struggles without judgement,” She adds that, “I am very productive in all aspects of life, I am a mom and have a career in advocacy.”

Mary Njeri**(not her real name), another benefactor of the tufunguke program, says that “a lot changed for me when I got discharged from a mental health facility, I had to face misconceptions and stigma surrounding taking psychiatric medication, something that interfered with my adherence.”

“It was at this point that a friend referred me to tufunguke where I was enrolled in their online support system that has enabled me to relate to other’ experiences thus helping me improve my medication adherence and self-care.”

Noting the impact of the program Gathoni advised, “it’s important to recognize that everyone’s healing journey is unique. If mental health issues persist or worsen, it’s crucial to seek professional help from a licensed mental health professional who can provide personalized guidance and support.”

Kenya is estimated to have about 7.5 million social media users. A majority of the users are aged 21-35 years according to a 2019 study by the Social Media Lab Africa (SIMElab) based at the United States International University, populations older than 35 years are rarely tech savvy and might not be able to benefit from most online initiatives.

Despite the Tufunguke online platform reaching a large number of people irrespective of geographical boundaries it may leave out a large group of people who might be in dire need unattended due to lack of access to internet services and access to smart phone.

However, the hospital is trying to bridge this gap by organizing in-person sessions and trainings targeted to high-risk individuals such as journalist, police, prisons, sportsmen and other vulnerable population, although unlike the online sessions organizing them has got huge financial implication.

Other strategies are Tufunguke tournaments, ‘Tufunguke na wanahabari,’ ‘Tufunguke na Wanaspoti,’ ‘Tufunguke Shuleni’ and Tufunguke campus tours where awareness of mental disorders particularly, the symptoms of mental ill health among the persons suffering from it and the community at large are created.

This story was first published in Health Business

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