Abstract:
Introduction: The Burden of mental disorder is greatwith the prevalence felt
globally.In Kenya like in many other African countries, mental health services had a
humble beginning until after independence that attempts were made to decentralize
mental health services to the provincial (regional) level. Health care providers
however face numerous challenges in the process of service delivery.
Objectives: The main objective of the study was to identify challenges health workers
faced in course of duty, factors contributing to the challenges and what strategies were
to be put in place to curb them.
Methodology: This was a cross- sectional study targeting all health workers in the
four psychiatric units under study. Qualitative and quantitative data was collected
using self-administered questionnaire as well KIs. Coding was done prior to data
collection in which five major themes were identified under which the respondents
were to discuss. The respondents were then asked to provide factors contributing to
the challenges and to further make recommendations on how to curb them. QRS
Nvivo version 10 software was used in the analysis of the data. The software formed
the basis for categorization, report generation and visualization of the data.
Results: A total of 46 respondents participated. Female respondents were 29. The
mean age of respondents was 38, a minimum of 23, maximum of 58 with a standard
deviation of 10. Majority (62%) were diploma holder, 19% degree holders, 8%
masters and 11% secondary certificate holders. Respondents included 32 nurses, 5
support staff, 4 occupational therapists, 4 social workers and 1 clinical officer. The
average salary was Ksh.50, 756 with a standard deviation of 18,918. The average
period of employment was 3 years with the lowest being 1 month while the
respondent who had been on employment the longest was 30 years. The identified
challenges were classified into 5 themes. Challenges related to work environment
included; unavailability of drugs, insecurity, limited resources, poor facilities and staff
shortage. Administration related challenges include; inadequate resource, poor
support and slow response to issues arising as well as poor management systems.
Challenges related to patient factors included; poor family support, poverty and
relapses. Colleague related challenges included; disagreements amongst staff, lateness
and absconding from duty and stigmatization. Finally challenges related to public
perception included; stigmatization. Factors contributing to the challenges were
identified as limited resources, neglect of the unit as well as poor public perception of
the unit. Suggestions to curb the challenges and they included; Increase and improve
the number of psychiatric facilities, increase awareness on mental illness to the
general public, recruit more health care staff in the unit, availing the necessary drugs
to the unit, improve on staff training and motivation as well as improvement on the
management systems.
Conclusion: Health care workers in psychiatric units indicated that they faced a lot of
challenges which could be attributed to environmental factors, patient related factors,
challenges related to seniors and those in management among other.
Recommendations: The government to increase the resource allocation to the
psychiatric units, as well as increase sponsorship to health care workers who want to
pursue a career in mental health.Hospital administrations to ensure that there is a
proper and conducive workenvironment, renovate existing structures, promote staff
empowerment, and recruit more health care staff.Health care workers should embrace
staff interactions and team work.