Abstract:
Background The government of Kenya has made progressive efforts towards improving mental health services
in the country. However there is little documentation of mental health services in the counties that would support
actualization of the legislative frameworks in the context of a devolved healthcare system. This study sought to
document existing mental health services within 4 counties in Western Kenya.
Methods We conducted a cross sectional descriptive survey of four counties using the World Health Organization,
Assessment Instrument for Mental Health Systems (WHO-AIMS). Data was collected in 2021, with 2020 being the
year of reference. We collected data from the facilities offering mental healthcare within the counties as well as from
County health policy makers and leaders.
Results Mental healthcare was provided at higher level facilities within the counties, with minimal structures at
primary care facilities. No county had a stand-alone policy on mental health services or dedicated budget for mental
healthcare. The national referral hospital, within Uasin-Gishu county, had a clear mental health budget for mental
health. The national facility in the region had a dedicated inpatient unit while the other three counties admitted
patients in general medical wards but had mental health outpatient clinics. The national hospital had a variety of
medication for mental health care while the rest of the counties had very few options with antipsychotics being the
most available. All the four counties reported submitting data on mental health to Kenya health information system
(KHIS). There were no clearly defined mental healthcare structures in the primary care level except for funded projects
under the National referral hospital and the referral mechanism was not well defined. There was no established
mental health research in the counties except that which was affiliated to the national referral hospital.
Conclusion In the four counties in Western Kenya, the mental health systems are limited and not well structured,
are faced with limited human and financial resources and there is lack of county specific legistrative frameworks to
support mental healthcare. We recommend that counties invest in structures to support provision of quality mental
healthcare to the people they serve.