USPKENYA PROGRAM REPORT VOL.

FOR THE YEAR 2012/2013

USERS AND SURVIVORS OF PSYCHIATRY IN KENYA (USPK)

1. NEWSLETTER USPKenya has been releasing a quarterly newsletter Titled The Kenya Psychosocial Disability Watch Edition. For dissemination purposes the organization has been using online forums and also printing hard copies which have been shared with different stakeholders. The newsletters have been released as follows Jan 2013 Edition: Focusing on our participation in legislative processes Download Link: http://www.scribd.com/doc/124186993/Kenya-Psychosocial-Disability-Watch-January 2013-Edition April 2013 Edition: Titled Rising voices about experiences of users Download Link: http://www.scribd.com/doc/171386906/Kenya-Psychosocial-Disability-April-2013-EditionNewsletter May 2013 Edition: Key focus on human rights violations meted against Persons with psychosocial disabilities. Download Link: http://www.scribd.com/doc/166699358/Kenya-Psychosocial-Disability-May-2013-EditionNewsletter August 2013 Edition: Titled best practices from Nyeri County Download Link: http://www.scribd.com/doc/171387758/Kenya-Psychosocial-Disability-August-2013Edition-Newsletter

2. LEGISLATION AND POLICY 1. Participation in developing and launching of a Legal Capacity briefing paper. In the year 2012 a technical committee was constituted by the Kenya National Commission on Human Rights to take the lead and dialogue on Article 12 of the Convention on Rights of Persons with Disabilities. USPKenya was part of the technical team that facilitated the process which culminated in the release of a briefing paper on legal capacity in the year 2013. The paper was later presented for validation by various stakeholders in Nairobi. Members of the Kiambu county support group were also involved in the process during a focused group discussion that was held by the consultant Elizabeth Kamundia. In the month of October the Kenya National Commission on Human Rights will be holding a following workshop to deliberate on the way forward on issues of legal capacity. USPKenya will be a key participant in the meeting.

(The consultant, Elizabeth Kamundia, during a Focus Group Discussion with members from Kiambu county) 2. Concluding observations by the committee against torture USPKenya also endorsed the concluding observations of the Committee Against Torture (CAT) on Kenya as adopted at its 50th Session as outlined below the organization pointed out the following issues to the CAT committee. The Committee is concerned by reports of deplorable conditions in psychiatric institutions and other places of deprivation of liberty and regrets the lack of information by the State party on the conditions in such institutions. (Article 16) We endorse the recommendation that, The Government of Kenya should ensure that all places of deprivation of liberty, including psychiatric hospitals, are adequately monitored and that effective safeguards are in place to prevent any ill-treatment of persons in such facilities. We would also urge the Government to provide detailed information on the place, time and periodicity of visits, including unannounced, to psychiatric institutions and other places of deprivation of liberty and on the findings and the follow-up on the outcome of such visits. We endorse the following recommendation: Considering that the Government of Kenya ratified the Convention in 1997, we support the Committees recommendation that urges Kenya to table, as a matter of urgency, the Prevention of Torture Bill (2011) before Parliament, so that its provisions, which include a comprehensive definition of torture in line with article 1 of the Convention and render all acts of torture punishable by appropriate penalties, become the applicable law. In addition we support the call for the ratification of the OPCAT: Recalling the State

Partys commitment during its Universal Periodic Review (UPR) in 2010 (A/HRC/15/8, para. 101.3), the Committee recommends that Kenya considers ratifying the Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. However we would also like to point out that Kenya signed the CRPD in 2007 and ratified in 2008. Article 16(3) of the CRPD also requires the monitoring of Mental Health Facilities The organization is also currently part of a team that is engaging with the CAT committee constituting of members countries which have been reviewed so far. The team consists of self advocates from the Netherlands, Japan, Estonia and the Czech Republic. 3. Participation in the Universal Periodic Reporting. In May 2013 the Kenya National Commission on Human Rights convened around table meeting with the following objectives a) To discuss strategies for moving the UPR process forward b) To discuss the process of developing a 3rd Annual Progress Report and in particular to agree on the themes for the report, teams, cluster conveners as well as timeline The emerging Issues for consideration for the 3rd Annual Progress Report were; (a) Review of the current themes in lieu of emerging human rights concerns and building consensus; (b) Review of cluster members and conveners; and (c) Develop a framework and timelines for preparation of the report; On Review of the current themes, the following themes were identified and what to cover: 1. Governance, Leadership & Accountability It was agreed that the theme is to be convened by the ICJ Kenya with KNHRC and Article 19 contributing to the theme. The theme was to cover; Devolution including Civic Education, Implementation of policies and funding for devolution Public participation in governance

Implementation of Chapter six of the constitution with regard to appointment of persons to hold public offices and how to deal with corrupt Public Officers and those who abuse those office

2. Access to Justice The Cluster Conveners of this theme are International Commission of Jurists (ICJ)Kenya , with KNCHR contributing. The theme was to cover: Judicial Reforms including vetting of Judges and Magistrates, Human rights jurisprudence from court decisions and rulings, Judicial transformation and Legal Aid Police Reforms including the process of appointments of senior officials, Vetting of those officers, Legislations for instance the National Police Service Commission and public participation in policing. Electoral reforms including the Legislative framework, Constitutional implementation, Representation for instance of the marginalized, minority and women, the role of Independent Electoral and Boundaries Commission (IEBC) in the Electoral Process.

3. Transitional Justice Theme to be convened by Kenya Human Rights Commission (KHRC) will cover: The Truth Justice and Reconciliation Commission (TJRC) Report and critically analyze the Mau-Mau issue on the report The International Criminal Court (ICC) including state cooperation with the ICC The Internally Displaced Persons (IDP) issue including reparation for the victims

4. Human Rights Defenders The theme is to be convened by National Council for Human Rights Defenders (NCHRD) with Independent Medico Legal Unit (IMLU), Article 19 and ICJ Kenya contributing to the theme. The theme to cover; Threats to Human Rights Defenders Judicial decisions Jubilee manifesto with regard to protection of human rights defenders Legislative framework

5. Freedom of Expression The Theme is to be covered by Article 19 and was to deal with; Media Law and regulation Freedom of Information (FOI) Bill 2012 Trends and jurisprudence on Freedom of Expression for the media

6. Death Penalty The Theme is to be covered by KNCHR and is to deal with; Findings for the survey on death penalty; The ICCPR and CAT concluding observations on the death penalty; Mental health for persons found guilty for offences punishable by death penalty

7. Torture and Ill Treatment The Theme is to be covered by IMLU and is to deal with; Illegal detentions Enforced disappearances Torture in mental health institutions Reparation for torture victims Pre-trial detention Renditions of terror suspects Report on Mt. Elgon cases

8. Rights of Refugees The Theme is to be covered by The Refugee Consortium of Kenya (RCK) and was to deal with: Documentations Conditions of Asylum Durable solutions

9. Children Rights The Theme is to be covered by The Children Foundation (CRADLE) and is to deal with: Budget monitoring Child Offenders Harmful cultural practices like the FGM, early childhood marriages and child abuse Protection of children from violence and exploitation Child labour and trafficking Street children

10. Women Rights The Theme is to be covered by FIDA Kenya and is to deal with: Legislation Access to justice Property ownership Reproductive health care Protection from harmful cultural practices SGBV 11. Rights of the Minorities and Indigenous People The Theme is to be covered by CEMIRIDE with PDNK, KHRC and Kenya Land Alliance contributing. Theme is to deal with; Legislation i.e. Community Land Bill The Role of ACHPR and its implementation AU policy framework on pastoralism Article 56 of the constitution

12. Persons with Disabilities The theme is to be covered by UDPK, with UDEK ,USP Kenya and KAIH and its networks contributing. It is to deal with; Mental Health Bill 2013 Conditions in mental health institutions Learners with Disability Act Access to Basic services Access to information for the deaf and blind Adjustment orders on buildings

13. Sexual Orientation The Theme was to be covered by KHRC pending registration of GALCK and is to deal with; LGB conveners to look at Implementation of UN Resolutions, Jurisprudence and Legislation Transgender conveners to look at Jurisprudence and Legislation with regard to protection Intersex conveners to look at Jurisprudence on their rights

14. Economic Social and Cultural Rights The Theme is to be covered by EACHRIGHTS with PDNK, Elimu yetu Coalition, KAIH and ICJ Kenya as contributors. The theme is to deal with; Right to education including Legislation e.g The Basic Education Bill, Free Primary education (tariff and non-tariff barriers), Access to free primary education for children with disabilities, Teacher-Children ratio and salaries, Allocation of educational funds, Vocational training facilities, Jubilee Manifesto in promoting basic education Concerns for pastoral communities with regard to setting up mobile structures for education Right to Health including Legislations, Pro-poor initiatives, maternal health, emergency treatment, doctors strike, access to basic health care, budget allocation and health institution management. Housing including squatter, historical land reforms and forceful evictions

Format

It was agreed that the format for the report will include the following: -

i. ii. iii.

iv.

Theme Summary of UPR Recommendations Progress on implementation ( This section to include an assessment of implementation of the 2nd Annual Progress Reports recommendations as well as assessment of emerging issues) Conclusion/ Recommendation

4. Mental Health Care Bill 2013 The organization has also been part of the reference team that has been reviewing the Mental Health Act with a view of aligning it with the new constitution and the CRPD. The process of engaging in developing the new bill has been challenging mostly because of how issues of legal capacity have been construed in the draft bill. Other contentious issues include forced treatment, deprivation of liberty on the basis of a disability and also the fact that the scope of the draft bill is too wide to the extent of purporting to legislate on issues of management of property where a person is deemed to lack capacity. We are however continuously engaging with other stakeholders with a view of make the bill compliant with the Constitution of Kenya 2010 and the CRPD. 5. Advocacy Public Education And Awareness As part of our ongoing media campaigns USPKenya was involved in various advocacy forums to create awareness on mental health issues more so in relation to the peer support programs in the four counties. The following are some links from a three day program that we featured in a breakfast morning show in the Kenya Television network.
http://www.youtube.com/watch?v=FwVLFtH0hf0 http://www.youtube.com/watch?v=TaJ8N76pDfc http://www.youtube.com/watch?v=Mf2fpy60xY0 http://www.youtube.com/watch?v=weSzvuLdZvQ

The following article was also featured in the Star Newspaper featuring self advocates from the organization.. http://www.the-star.co.ke/news/article-120600/against-all-odds-young-people-livingmental-illness USPKenya also featured on UP Nairobi Urban Perspective as outlined below
http://www.upnairobi.com/dt_portfolio/the-mental-health-crisis-in-kenya/

6. PEER SUPPORT GROUP INITIATIVE (EXPERTS BY EXPERIENCE ) USPKenya was able to establish five support groups in four counties namely Nairobi, Kiambu, Nyeri and Nakuru. The first three support groups were operational from September 2012 while the Nakuru support group was established in March 2013. It was not possible for the organization to launch the peer support program in Eldoret County due to lack of support from the local district and provincial hospital even after numerous meetings to the county with various stakeholders. All the support groups have been receiving rights-based trainings through USPKenya in the area of

psychosocial disability, mental health covering diverse topics such as: understanding mental health; living and caring for a person with a psychosocial disability by respecting their inherent dignity; and empowering persons with psychosocial disability to lead productive lives. The human rights trainings focus on the Constitution of Kenya, the Persons with Disabilities Act (2003) and the Convention on the Rights of Persons with Disabilities (CRPD).
The support groups are established as follows County Nairobi Kiambu Nyeri(Karatina) Nyeri(Karaba) Nakuru Total No of Members 60 20 45 25 16 166 Location Nairobi Kikuyu Karatina Mathari East Nakuru

1. Nairobi County The Nairobi Peer support group has been meeting twice per month and mostly consists of professionals. The group has been actively involved in advocacy at the National level as highlighted in this report, whereby most of the members who participated in awareness creation programs are from Nairobi. The group has also been involved in initiatives geared towards fighting discriminatory practices against persons with psychosocial disabilities e.g. on the on-going efforts for users/survivors to be granted the tax exemption from the Kenya

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Revenue Authority. Most of the members have also been able to make free and informed decisions in the area of health care, child custody and also in financial management. Its worth noting that one of the members whose child had been taken away by the relatives on the presumption that she was not in a position to take care of her, was reunited with her child through concerted efforts between the organization and FIDA (Federation of women lawyers, Kenyan Chapter). A good number of the members also have been spared the agony of going through controversial medical procedures like ECT (Electro Convulsive Therapy) by empowering them on their right to free and informed consent. Most of the group members have also reported better interactions with their families, increased level of selfconsciousness and self- esteem. The members are more assertive in most areas of their lives e.g. school, employment health, etc 2. Kiambu County This peer support group is based in Lusigetti area and meets at the L ocal Chiefs Office at Karai compound every first Friday of the month. It comprises of about 20 members of whom some are carers and the majority users/survivors. Most of the members are elderly women engaged in various self-help group activities such as subsistence farming and livestock rearing. The group is duly registered as a self-help group by the Ministry of Gender and Social Services. The members have been contributing a certain amount of money every month, which is normally loaned to the group members who in turn engage in small scale farming and businesses.

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(Kiambu County Peer Support Group members )

3. Nyeri County The group has been meeting on a monthly basis at the Karatina District hospital. It has expanded from an initial membership of 20 to a total membership of around 45. The membership had grown to over 60 but the group members decided to create an extra support group to cater for the needs of the other members who were traveling for a long distance in order for them to attend the support group. The Karatina Mental Health

Group in Nyeri County is leading the way to show that rural areas have as much opportunity as urban areas in advancing the rights of persons with psychosocial disability. The group was duly registered by the department of Gender and Social Services in August 2012. Initially it consisted of members from Karaba and Karatina totaling over 60 members. The membership include users, survivors and caregivers, representing 12

both men and women. Coming from a mostly rural area, in terms of occupation, many members are small scale traders in the local market, farmers, carpenters and casual laborers. Additionally, a few of the members are professionals working in different sectors. The group is chaired by Agnes Wangechi. The secretary who also doubles up as the Chairman of the USPKenya board is Andrew Kimondo. The treasurer is also a person with a psychosocial disability. The Karatina Peer support group has adopted a model where persons with psychosocial disability are not passive but rather active in demanding their rights and finding opportunity to live meaningful and productive lives on an equal basis with others in spite of their disability. This approach has been successful as demonstrated by the following key engagements at the grassroots level. Exemption from paying County-Council Levy Fees Members who are in the support group do not pay the county council levy fees in order to run their trade in the market. However, it never used to be like this. What did the group members do? Every trader in the market has to pay a certain fee in order to run a stall in the market. For the traders with psychosocial disability, this in itself is a challenge as many of them live in poverty. Some are also unable to engage in business activities throughout unlike their counterparts. In addition to meeting their normal daily needs like food and shelter, most persons with psychosocial disability have to put into considerations costs of healthcare e.g. medication, counseling and hospitalization. Due to this, there was a need to advocate for a waiver on the fees being levied by the County Council. We knew that the people with physical disability did not pay the town council levy and we had to also state our case to the town clerk and through the trainings we have received we knew that we were persons with disabilities and should be treated on an equal basis with others. We had to make this known to the town clerk in order to get exemption so that our members could have extra money to meet their daily needs and cost of healthcare, said Lucy who led a delegation to the Town Clerk offices.

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The main problem however for the group was that unlike persons with physical disability who have cards identifying them as persons with disability and whose disabilities are visible, persons with psychosocial disability had not been issued with such cards and this was compounded by the fact that the disability is invisible. But where there is a will there is a way and they could not back off and let members be discriminated; because they understood that persons with psychosocial disability should be treated on an equal basis with others without prejudice and discrimination. It is for this reason that we spoke with the doctor in the hospital s o that members from our group could be assessed and issued with a form to show the town clerk that they are persons with disability hence are exempted from paying the county council levies but we are still following up on the cards, noted another member in the delegation. Additionally, through this form, the members are now engaging with the Department of Gender and Social Services to be given grants to invest in livelihood projects. Grace Wangui who sells farm produce in the market is happy that she does not have to pay the market levies saying that there was a time she could not conduct business in the market due to the inability to meet the city council levies. This, as she said, would make her beg for food as she did not have an income. Now I am able to make money and do not have to beg anymore. REDUCED COSTS AT THE HOSPITAL Getting medicine was another challenge that the members in the support group faced. It is well known that there are members who got sick and probably had no money; so when they went to the hospital they could not be treated and normally they will be turned away. Usually when one went to the hospital; they paid a fee of Sh. 50 for the hospital card, Sh. 50 at the clinic and Sh. 50 for an injection or medication. We spoke with the doctor in charge and explained the challenges our members face, said Kimondo. It was then agreed that for psychiatric patients in the support group, there was no need to go through this process. Their cards are put in a common place so that when they go to the hospital they are exempted from paying for the hospital card. Additionally, if there is a dire case, they are not turned away rather the doctor will still attend to them. Now most members are happy that they can access services at a lower cost and as members of the support group are assured that even if they require medical attention and have no money; they shall not be turned away from the hospital without treatment. 14

BURSARY FROM THE COMMUNITY DEVELOPMENT FUND Another area where the group has made strides as a result of the trainings received that have empowered them is to also claim their space as persons with disability in the area of education within the Community Development Fund (CDF). Our members face a lot of financial difficulties and as a result some of the children drop out of school, said Agnes, a member. As officials they felt that they also had to take advantage of the bursaries offered in the constituency. We decided to pay a visit to our area Member of Parliament to state our case. It took us three months to get to talk to him; in all those days we tried and did not manage we did not give up, recalled Lucy. Eventually when we got to talk to him; we explained that we are members of a group of persons with psychosocial disability and needed to benefit from the CDF just like any other person in the constituency. Currently there are four children in high school that have benefitted from the bursaries from the CDF whose parents are persons with psychosocial disabilities in the support group. Alice Wanjirus son benefited from the bursary. She is a casual labourer and said that she was very happy that she had got a break from begging teachers not to send her son home because of lack of school fees. EMPLOYMENT Additionally, the support group has been able to advocate for three of their members to get casual employment at the town council services. Agnes Wangechi, the chairlady of the support group in Karatina is happy of the strides they have made and is grateful that USPKenya has invested time in training them on human rights. She says that now in the community many people accept their members as persons with disability as opposed to a while back when all they could think of when they saw them was that these were mad people. She is also happy that even the government, through the Member of Parliament, the CDF, the town council and even the doctors in charge at the district hospital are also gradually respecting their human rights while at the same time promoting their inclusion within the family and community system as persons with disabilities.

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Mechanisms of addressing abuse within the community set-up The support group has encountered cases where members are abused through violence in their homes by virtue of having a psychosocial disability. The group has embraced a dialogue model in these cases where they pay a visit to the affected homes and dialogue with the family members to understand the origin of violence on the affected person. They involve the local authority and the church in such cases. The approach is not to blame the abusers, but to understand why they resort to violence and helping them to respect the human rights and inherent dignity of persons with mental health conditions. Changes in interaction The officials of the support group acknowledge that so much has changed among members as a result of continued interaction between members and receiving training from USPKenya. For example Andrew Kimondo, an official in the group, says that initially when caregivers came to the group many did not know how to live with the affected person; how to handle them when in a crisis; but with time, as he sees it, they have some sense of direction; of how to handle and care for their loved ones. The area being in the town, Andrew says that now there are few people loitering in the streets as a result of them being unwell. Even in the support group itself, some of the members initially used to be a little unsure but Andrew asserts that with time; there is a lot more awareness of what is expected of them, and there is a willingness to learn and understand their conditions. SUSTAINABILITY For the support group; measures to keep going strong are evident from the officials willingness to run the support group and the commitment of the members. The group has a bank account. Members contribute Ksh. 100 on a monthly basis which is deposited to the group bank account. The officials are responsible for operating the account within the mandate given by the members. The peer support group is also seeking other ways of ensuring the sustainability of the support group. This will be realized through the following key strategies:

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The group is currently submitting proposals to the National Council for Persons with Disability, the CDF and Njaa Marufuku (Government agricultural programme to eliminate hunger). The group is also considering applying for funds from the Women Enterprise Fund since the majority of the members are women.

(Karatina peer support group during one of the trainings.)

Karaba support group The group was crafted out from the Karatina support group in Nyeri County since most of the members from this group were coming from a long distance. They were able to advocate together for services to be brought within their local community. The group was officially established in April 2013 and currently has a membership of 25. It is currently 17

undergoing formal registration processes through the relevant local authority so that it can be able to engage better with the local devolved government. The Karaba support group is currently under the mentorship of the Karatina mental health support group

(Members of the Karaba support group during a registration process.) Nakuru Support group The group was duly established in March 2013 with the support of the Rift valley provincial general hospital in Nakuru town. Currently the group has 16 members who are mainly drawn within the suburb of Nakuru town. They meet once, every last Friday of the month at Langa langa health centre where they are provided with a room by the local district hospital. The group is also undergoing registration through the support of the hospital medical officer. Some of the members of the group have been participating in various trainings by USPKenya in order to improve the capacity of the members who are relatively new. One of the members of this new group sits in the board of USPKenya in order to represent the interest of this county in the national user movement.

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(Members of the Nakuru peer support group at the langa langa health centre) 4. SOCIAL MEDIA USPKenya continues to run a facebook resource centre whereby different materials are normally disseminated through. The organization also has an active twitter account . 5. ONLINE PEER SUPPORT The organization has created an invitation only Facebook page for our peer support group members. This enhances interaction in a safe and private environment at their convenience in between the physical support group meetings. 6. DOCUMENTARY USPKenya has produced an educative and entertaining documentary in collaboration with the Vioja Mahakamani Troupe which features in the Kenya Broadcasting Corporation (KBC). The documentary highlights the lives of a person with psychosocial disability who is chained and isolated from the community on the basis of his disability. The issues of stigma, discrimination and poverty are interwoven to demonstrate the challenges that are faced by Persons with Psychosocial disabilities in Kenya. The cross cutting issues of cultural and gender influence are also illustrated.

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Kindly find the Video

7. OTHER LOCAL AND INTERNATIONAL ENGAGEMENTS Cape Town 2013 strengthening our voices

USPKenya being a member of the World Network of Users and Survivors of Psychiatry participated in a global forum Between 13th and 18th of May 2013, 18 participants in the World Network of Users and Survivors of Psychiatry (WNUSP) gathered in Cape Town, South Africa for a historic information-sharing and strategy-building seminar. The name of this event was Strengthening Our Voices. The Cape Town seminar brought together individual experts, activists and leaders from the grassroots political movement of users and survivors of psychiatry and people with psychosocial disabilities in five world regions: Asia, Europe, Latin America, North America and the host continent Africa. It was a unique occasion to share and debate opportunities and barriers for advocacy and to build towards an enhanced strategy to promote and protect the rights of all our people international
PANEL DISCUSSION WITH THE OPEN SOCIETY FOUNDATION BOARD MEMBERS HELD IN NAIROBI ON 12th APRIL 2013 The panel discussion was held to deliberate on the ongoing work around disability rights in Eastern Africa. The panel moderator was Boaz Muhumuza, OSIEAs disability rights officer and the forum was graced by OSF global members and also colleagues from the Open Society Foundation. USPKenya was represented in the meeting by Michael Njenga the Heads of Programs. Some of the key areas of discussion was on the general situation of the rights of persons with psychosocial disabilities in Kenya? Michael stated that persons with psychosocial disabilities are among the most marginalized in Kenya in terms of the realization, enjoyment, protection and advancement of their human rights. This situation is compounded by a number of factors like: rampant stigma and discrimination in all spheres of life e.g. employment, family life, access to health e.t.c. They are also subjected to human rights violations at both the community and also with in institution. This is accentuated by social exclusion, extreme poverty and discriminatory laws and policies. USPKenya highlighted some of the key areas that it has been working on with the support of the Disability Rights Initiative including building the capacity of users/survivors to be better self advocate, participation in various policy and legislation initiatives and also the peer support groups as an avenue for building a vibrant grassroots movement. Michael retaliated that despite all this challenges the following opportunities existed for the user movement in Kenya Strengthened user/survivors movement both at the grassroots and national level

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Strategic Collaboration with Kenya National Commission on Human Rights and FIDA federation of womens lawyers Kenya chapter and the cross disability movement New constitutional dispensation and devolved government structures A reformed and progressive judiciary

PARTICIPATION IN THE 5TH DISABILITY LAW SUMMER SCHOOL AT NUI GALWAY FROM JUNE 17th to 22nd 2013 USPKenya is grateful to the Open Society Foundation for granting one of its staff the financial support to attend the 5th Summer school at Nui Galway. The purpose of this five and a half day International Disability Summer School was to equip participants with the insights and skills necessary to translate the generalities of the UN Convention on the Rights of Persons with Disabilities into tangible reform for persons with disabilities. The core focus was on Voice and Choice connecting reform on legal capacity with reform on the right to community living. The summer school was highly valuable to the organisation more so due to the anticipated reforms on Article 12 of the CRPD

8. CAPACITY BUILDING FOR PERSONS WITH PSYCHOSOCIAL DISABILITIES, CARE GIVERS AND THE MEDIA.
CARER GIVERS MEETING HELD IN LIMURU

This was a capacity building workshop which was organized to empower care givers of persons with psychosocial disabilities. The trainer, who was also a care giver welcomed and facilitated introductions to all in attendance. He gave a brief history of his family citing that he was a care giver of his son who had the condition of autism. He had started the group called Muringiti which had brought together parents who were caring for persons with either psychosocial or intellectual disabilities. This being an all adult attendance, participatory method of training was used whereby those in attendance shared their experiences and the best practices that they had used over time. To break the ice, the trainer shared his experience of his son. The son was attending school and his teachers were very understanding and quite supportive. He pointed out that some of his friends had wanted him to hide the son but he had made a decision not to discriminate him. A mother whose daughter had a psychosocial disability was happy to report that her thirty six year old daughter had received support from the government, having been given a sewing machine for sewing cardigans in order for her to engage in productive living. A participant wondered how she could help her son who had a psychosocial disability and frequently refused to take his medication. She noted that every time the son declined medication, he would get a relapse and the only way would be to use force 21

and be taken to hospital. However, she was advised that the solution would be getting to talk to the person and get to know the reason of not wanting to take medication, and this would avoid forced treatment. Another carer shared how her forty five year old daughter had given birth to a son who had a disability, and she was asking whether there was any relation between the daughters disability, with the boys disability. Advice was given that it is always good to contact the doctor to find out if the medications are good with pregnancy, to avoid complications and also to avoid such eventualities. A carer shared of how her son got sick and was admitted at Mathare mental hospital. She reported that every time the son was discharged, he was not any better but rather grew worse. It was noted that in Mathare hospital there may not be much progress as opposed to being around home. Seeking medical attention with in the community and going back home was seen as the best model as the person with the psychosocial disability would be in a communal environment. The facilitators explained that Community mental health care reduces the issues of stigma and human rights violations which are associated with institutions. It was agreed that it was important for everyone to come together so that they could advocate for services to be delivered within their local community health facilities. Another care giver shared about her middle aged son whose wife had disappeared with his children after she learnt that her husband had a psychosocial disability. The son was very affected by what happened that he has not re-married again. The participants noted that it would be good for any person having a psychosocial disability to explain to his or her prospective spouse that they have this kind of a disability and on how to cope with the issue when they get married. This was seen as a factor that would decrease the rate of separation and promote more understanding in the relationship. An experience was shared by a care giver on how tough it gets caring for her grandson who is epileptic. She narrated how she is forced to keep him locked up in order to restrict his movement. She understood very well that she was interfering with his freedom of movement but on the other hand, it was only the way she knew of handling the epileptic child especially in the absence of state social support. She informed that on the day of the workshop she had left having locked him alone in the house to avoid him wandering and perhaps harming himself. She added that years of caring for this grandchild had largely taken toil on her health.

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The facilitator encouraged the carers to take care of their health; to accept themselves and also accept the persons with psychosocial disability that they were caring for. They were also advised to register with the department of gender and social services within their counties so that they could benefit from the social protection program that is being piloted in all the constituencies in Kenya The following were ways that were discussed in the workshop on how to care for persons with psychosocial disabilities: Carers were sensitized against using culture, to describe the disability of those they were caring for e.g. saying that the disability was a curse, associating it with the family tree history or associating the disability as being possessed by devils/demons.

It was clarified that a person with a psychosocial disability is not devil/demons possessed. For those with school going children who had a psychosocial or intellectual disability, they were advised that these children should not be concealed or locked up but rather they should be taken to school and participate in other activities within their community on an equal basis with other children of the same age. The carers were advised to support adults who had psychosocial disabilities to engage in productive living like other members of the society. Care and consultation on medication while expectant was needed as some medication could be harmful to the unborn child and this could easily lead to a child acquiring a disability. The women were sensitized against using some of the bleaching agents on their skin which could affect their health and also by extension, affect unborn children The care givers were sensitized on the need to manage stress, develop good coping and support mechanisms within the family in order to minimize the possibility of triggering a relapse. It was good to keep on reminding those on medication to keep taking their dose as advised by the doctor. It was noted that there was need to uphold proper hygiene for persons with psychosocial disability. Good grooming was also paramount. The carer givers were urged to respect the human rights of their loved ones irrespective of their disabilities. They were also sensitized on the need to respect the will and preferences of persons with psychosocial disabilities.

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An appeal was made to all the carers that they should protect those they cared for against exploitation e.g. providing cheap labour or servitude as farmhands or housemaids if a person with a psychosocial disability are employed they should always be paid commensurate to the work done. The carers that were supporting children were sensitized on the importance of treating them on an equal basis without any discrimination e.g. buying clothes befitting their age but not making them wear clothes that have been worn by other children in the family. Those with female children were sensitized on the importance of buying sanitary pads. The importance of addressing issues e.g. death, trauma, violence against women was highlighted. It was noted that there is a need to talk and address such issues since some of them cannot be handled using medical interventions. Care givers were advised to be sensitive and accommodate persons with psychosocial disabilities by avoiding confrontational situations for proper coexistence within the family. Carers of girls and women with psychosocial disability were encouraged to be extra careful in order to avoid gender based violence e.g. child molestation and rape

As this session came to an end, there was agreement that persons with psychosocial disabilities have a right to getting married; and there was need to advice prospective partners on how to live together. Human Rights In the second session, the following human rights were discussed as provided for in the Constitution of Kenya, CRPD and Persons with Disability Act 2003 (PWD Act 2003). The care givers were sensitized on the following key human rights: Right to inherent dignity Access to justice e.g. the right to take a case to court Right to privacy Right to own property Right to education; hence should not hide children and fail to take them to school which is a punishable offence under the PWD Act 2003. Freedom of movement Right to information, identification Right to work 24

Right not to be exploited, e.g. Earning an amount which is not commensurate to the work done Right to clean environment Right to consumer protection Right to access health services which are affordable, appropriate and available on the basis of free and informed consent Right to self autonomy and determination i.e. the right by a person to make his own decision/choices

One of the carers narrated the following experience

My son did not want some medication because of the side effects. He would take the medication and would really tremble. Since this was a side effect of the drugs prescribed, we went to the same doctor and reported of the severe side effects that the drugs were causing. The doctor was quite considerate and cooperative. The medication was changed and even recently he asked for them to be changed again, which was done.

As the session came to an end the carers were asked to be more vigilant and be on the lookout on some medication that purported to heal mental illness as unverified medication could lead to dire side effects. As the workshop meeting ended, the participants expressed their gratitude to have been empowered and they pledged to put into practice what they had learnt.

Carers Capacity building workshop held in Nyeri County

The meeting started with introductions from the carers who were present. As they introduced themselves, they described the conditions of the persons they were taking care of and they also stated the challenges that they faced. Some of the challenges included: Persons with psychosocial disabilitys failure to take medication Failure to keep their clinic appointments 25

Failure to attend peer support meetings Hot temper and irritability from some of the persons with psychosocial disabilities

The facilitator however, stated that how persons with psychosocial disabilities behave, largely depends on how their carers treat them. The facilitator trained on best practices while caring for persons with psychosocial disabilities. General Principles of Caring for persons with psychosocial disabilities 1. Communication The carers were sensitized on ensuring that communication is clear, empathic, and sensitive to persons with psychosocial disabilities. Be friendly, respectful and nonjudgmental at all times. Use simple and clear language.

The carers were advised to be using a language that those they were caring for would understand. In the cases of disclosure of private and distressing information (e.g. regarding sexual assault or self-harm) a carer should respond with sensitivity Provide information to the person on their health status in terms that they can understand and also ask the person for their own understanding of the condition. Then try to explain to them.

2. Assessment The carers were advised to Note the history of the presenting complaint(s), past history and family history, as relevant as possible. Have a chronological order of the disability as it may help the doctor Assess, manage or refer, as appropriate, for any concurrent medical conditions. This is especially important as a diagnosis is made Assessing for psychosocial problems, noting the past and ongoing social and relationship issues, living and financial circumstances, and any other ongoing stressful life events. This will help the carer in monitoring the progress of the person

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3. Treatment and monitoring; The carer should Determine the importance of the treatment to the person as well as their readiness to participate in their care. Try and reason with the person with psychosocial disability The carers were asked to determine the goals for treatment for the affected person and create a management plan that respects their preferences for care Try and devise a plan for treatment continuation and follow-up, in consultation with the person. Continually monitor for treatment effects and outcomes, drug interactions (including with alcohol, over-the-counter medication and complementary/traditional medicines), and adverse effects from treatment, and adjust accordingly. Make efforts to link the person to community support e.g. peer support groups. Encourage self-monitoring of symptoms and explain when to seek care immediately. Ensure to treat persons with psychosocial disabilities in a holistic manner, meeting the mental health needs of people with physical disabilities, as well as their physical health needs.

4. In mobilizing and providing social support, the carers were asked to: Be sensitive to social challenges that the person may face, and note how these may influence the physical and mental health and well-being. Where appropriate, involve the carer or family member in the persons care. Encourage involvement in self-help and family support groups, where available. Identify and mobilize possible sources of social and community support in the local area that include vocational support.

5. Attention to overall well-being The carers should: Provide advice about physical activity and healthy body weight maintenance. Sensitize persons with psychosocial disabilities about harmful alcohol use and cigarette smoking Encourage cessation of tobacco and substance use. Provide education about other risky behaviour (e.g. unprotected sex). Conduct regular physical health checks. Prepare people for developmental life changes, such as puberty and menopause, and provide the necessary support.

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Discuss plans for pregnancy and contraception methods with women of childbearing age.

Human Rights
The facilitator also sensitized the carers on some of the rights of persons with psychosocial disabilities. Right to privacy This is where the carers were informed that they needed to let persons with psychosocial disabilities have moments of privacy. Right of Movement The issue of restricting movement of persons with psychosocial disabilities was addressed. It was agreed that instead of locking them up, it was better to have one around them to watch over them. Payment of labour commensurate to the work done Most carers agreed that persons with disabilities were exploited and that they got less wages compared to other persons. There was need to claim for their rights. Right to clean environment, clean food There was need for keeping the environment tidy and habitable of persons with psychosocial disabilities. Also the utensils and food given to these persons ought to be clean and fit for human consumption Right of expression This was seen as the vital as carers were sensitized on listening and reasoning out with the persons they were caring for. Right to information This was especially important in explaining to the person of his/her disability and also on the medication administered. Consumer rights

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An example was given of how a person with a psychosocial disability was sent to the shop, only for him to be sold to a stale loaf of bread. Therefore there was need to protect persons with psychosocial disabilities from such entrepreneurs.

As the session came to an end the carers a call was made to the carers to ensure that users continue using medication for their wellness and well being. This would also increase their productivity and lead independent lives. As the workshop meeting ended, the participants voiced their gratitude to have been empowered and they pledged to put into practice what they had learnt.
SUPPORT GROUP LEADERS NETWORKING MEETING HELD ON 28 JUNE 2013 AT THE PEARL PALACE HOTEL IN NAIROBI
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USPKenya organized a meeting to meet the 8 support group leaders from the four (4) counties in Kenya namely Nairobi, Kiambu, Nakuru and Nyeri. The Heads of Programs at USPKenya, Michael Njenga, welcomed the participants who were in attendance. He asked and encouraged all in attendance to participate in the workshop in discussing and sharing the issues, knowledge and experiences at the grassroots. The participants introduced themselves after which some certain ground rules were set for the session. The modalities for discussion was guided by but not limited to these questions o o o o Why are we here? How can we make our grassroots movement sustainable for posterity? How can we in the grassroots support USPKenya? What is each support group doing in the grassroots and what are the best practices that other support groups can replicate?

The participants were reminded that they were all in attendance to share knowledge and also develop strategies of strengthening the grassroots movement. Interactive sessions were highly encouraged as the workshop was all about exchanging ideas, gaining knowledge from each other and also looking at the way forward, in terms of the support groups. The group leaders from Nyeri County took the lead and shared what they were doing at the grassroots. This is the transcript of what they shared. Our support group, in Nyeri County, has been involved in various activities in the grassroots. We meet once every month from 10am on a date that is usually agreed upon by all the members during the support group meetings. A few months ago, we approached the district hospital and had a talk with the psychiatric nurse on two issues. One was about the inability of our members to afford funds for medication and injections. The second issue was on how our members of the support group were handled once they were at the health institution for

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example the language that was being used by the medical officers. After having a talk with the psychiatric nurse, he referred me to the chief psychiatrist where I presented the names of our support group members , to the main doctor who signed in order for some money to be allocated to cover the expenses of our support group members once they sought medical services. This was done and since then, to date, no member of our support group pays any consultation or incurs medical expenses in terms of medication and injections as this has been waivered. The second issue was on how members of our support group were being handled at the hospital. We talked this over with the psychiatric nurse who promised that our members would have direct access to the psychiatrist without the long queues and also promised to talk to the hospital about the way they addressed persons with psychosocial disabilities. We have also approached the local authorities in our area whereby those members of our support group that conduct their businesses at the local market, the levies have been waivered and they are able to conduct their business without paying the levy. We have also registered the group at the Ministry of Culture and Social services whereby we are trying to save money in order to start an enterprising project. We have engaged the local county council in discussions and the council is willing to employ members of our group in the casual sector at an average wage of ksh 170 per day (2dollars). We have also approached a local bank (Equity Bank) to hold talks on the possibility of some of our educated members being employed for clerical jobs and also for them to include us in their financial literacy program. These talks are still on-going and we hope they are going to be fruitful in the near future. We have also established contacts with principals of different schools in our county to see if some of our members can be employed by the board of governors in these schools. Our group has created awareness in Karatina, Nyeri County by talking to most of the stakeholders in the county. Our membership is of 40 members with even more people wanting to join us. It was categorically stated that persons with psychosocial disabilities have the right to to the highest attainable standard of health, which includes the right to health care services, including reproductive health care in line with Article 43(1) of the Constitution of Kenya (CoK 2010) while at the same in line with Article 54(1) A person with any disability is entitled (a) to be treated with dignity and respect and to be addressed and referred to in a manner that is not demeaning. As this workshop was interactive, some participants sought to know more on how the Karatina support group was able to save money and on the support needs of the persons who were seeking employment in various institutions mentioned above. The members of our support group save money that we are given individually by USPKenya, as reimbursement of our transport which is deposited into our bank account. Some of our members have various needs and those that can sustain work for a few hours get the casual jobs. Others work in farms while the rest run small scale businesses in the local market. In the event that a person with psychosocial disability is not able to hold a job, the local authorities has promised to employ the caregiver in such a situation. As the meeting progressed, the moderator noticed that as the support group leaders talked about their members in the various support groups, they referred to them as sick or patients. This was noted to be stigmatizing and there was need for a complete shift from the

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medical model to a social or human rights model of disability. That was agreed upon but there was a barrier on how a disability would be termed in Swahili. This was left pending as further research was needed. The concept of disability was defined as arising from the interaction between the impairment (illness) and environmental or attitudinal barriers .There was need to shift away from the medical model to the human rights model. The Karatina support group leader continued sharing their experiences on how they were handling issues emerging at the grassroots. We are currently engaging our member of parliament (MP) about the constituency development fund for persons with psychosocial disabilities. The MP at the time of the talks was and is very willing to work with our support group and also in availing the funds to us. At this juncture the secretary of the support group indicated that there was need to include another member in the committee so that the secretary could have a support person as she goes round engaging with the local authorities. It was however discussed in the workshop that users should be at the fore-front in advocating for their rights and that carers should only support their activities. The secretary of the Karatina support group was concerned that she had recently learnt that funds meant for persons with mental disability in the county, had been available yet the funds were sent back to the treasury as the local authorities were not aware of any existing groups concerned with the welfare of persons with mental disability. However all is not lost as a local NGO has requested the secretary of the support group to organize and fill the names of the members of the support group in order to be given blankets, water tanks and mattresses. The moderator cut in and stated that people have power especially at the grassroots level. He added that since the government was devolving, establishing contact with the county government was paramount and that the Karatina support group was headed to the right direction. The Nyeri County support group having completed sharing of experiences, it was now the turn of the Kiambu County support group to share. This is their transcript as shared by the chairman of the group: The Nyeri County group has done incredibly well in their community and I want to applaud them for that work. I have learnt so much and there is a lot that I can replicate in our group. I now know it is possible to engage the local authority, the health institutions, the schools around and the community at large. I would just like to know how you approached the local authorities. The secretary of the support group in Nyeri county answered that she always wrote an introduction letter, but more so, she uses her previous networks as she had worked with the red-cross previously, hence she knew most of the offices.

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After clarifying how she managed to talk and engage with the local authorities, the chairman of the Kiambu county support group picked from where he had stopped, and started with a brief history of their support group. Our support group is registered as vulnerable group outreach. It was started because persons with mental disabilities just stayed at home without knowing what to do or where to get help. So this prompted me and others to register a group that brought together persons with psychosocial disabilities. A local NGO called Basic Needs approached us and was willing to support our members in accessing medication. This was of so much help to our members who previously could not afford medication. Unfortunately, this programme only ran for two (2) years then the donor pulled out. This led to our members withdrawing themselves from accessing medical health care as they could not meet the monthly cost of the hospital bills. So we have started looking at sustainable ideas and we now have contributions which we loan to our members to start small enterprises so that they can make a living that will enable them pay for their medication and other basic needs. We also have some savings in the bank looking for ways in which we can invest it. We have some new members who have expressed interest in registering and that will mean more money for the group in terms of yearly contribution. I have been trying to engage the hospital to see if our members can be treated for free, and every time we approach the institution, we find a different doctor from the previous one who had talked to us on the possibility of getting free medication. At this point, the chairlady of the Karatina support group chipped in and advised that for the sake of future reference, it is always good to have documentation anytime the Kiambu support group talks with a doctor as this would form a basis of reference should a doctor be transferred to another station. It was decided that as much as food assistance from the authorities was good, it would be much better if the support was much more structured for sustainability and for the universal good of the persons with psychosocial disabilities. The moderator raised issue on the best model that would be used in engaging the local community. The charity model was mentioned that it would only work for a short term and it was not sustainable. However the human rights approach was seen as the best as it was empowering and self-sustaining because it looks at the rights of the persons with disability and enables them to access government services on an equal basis with others in the community. It was now the turn of the Nakuru support group leaders to share what they were doing in their group. The chair started by saying that she had been so much impressed by the progress that the Karatina group had made. This is the transcript: I have learnt so much from the previous speakers which I will borrow and implement in our support group. Our support group is relatively new, and we are yet to put the strategies in place. We have been contributing a little from the allowances that we are given but I have learnt that we can even contribute from our pockets in order to increase our savings. I was going through

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these points that I would like to share with you. It would be a good idea to have our own resource center where literature on mental health is displayed and also a place where counseling would be done in times of crisis or relapses. Again, it would be nice to keep records and most importantly brainstorm on ways to create awareness in the community. This creating of awareness is important as one gets to be misunderstood by the family or may affect a marriage incase the spouse is not understanding. The moderator explained that there was need to look at the barriers that forced one not to be productive and that in most times, it is the environment or the lack of reasonable accommodation that make one disabled and that it has nothing to do with the person. There was a concern over a case where a participant narrated how a certain school had failed to register a child for the national examination because the child had a psychosocial disability. He was advised that it was not too late and since it is the right of that child to access education, then it was the onus of the parent and also the support group leader to ensure that the child went back to school, though the first thing was to understand the situation of the child and see the best interest of this child. A participant was happy to share that being a member of USPKenya was the best thing that happened to him. He was now much more aware and more vocal in looking out for his rights. He narrated how his colleague was fired from employment on the basis of his mental health. This participant was quick to add that if that happened today, he would be more assertive in encouraging the friend to seek measures of reasonable accommodation at the work place. There was applause for USPKenya and all its partners for the noble work they were doing in empowering persons with psychosocial disabilities and in promoting their rights. In the afternoon session, the workshop sought to look at sustainable mechanism for the support groups and also how the grassroots groups would work with USPKenya. Some of the participants noted that to be more effective in the grassroots, the leaders should get some financial help in order to facilitate their movement. For sustainability, it was agreed that the youth and middle aged should be encouraged to join the support groups and be involved in the group and community activities. There was a suggestion that leaders of one support group could be invited to go and disseminate information in another group, this is because a stranger is always well received in a far off land. Once this is done, then the persons being trained will be curious to learn more and will approach their local support group leaders. Also USPKenya members can go to the grassroots and talk to the locals and work with the church and the local authority. The benefit of working with the local authorities was highlighted by the Karatina group which stated that they had been given a land where they could conduct bee keeping as a means of economical empowerment.

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Way Forward All participants were encouraged on the importance of engaging with the local authorities especially with the new devolved system of government. Also there was need for persons with psychosocial disabilities to register themselves with the National Council of Persons with Disabilities (NCPWDs). Document all discussions and deliberations with the local devolved government for future reference and follow up Have targeted advocacy awareness programmes to counter stigma and discrimination at the local level. Have continuous exchange programs where support group leaders of different groups share knowledge and information with members of groups. Engage and develop programs which are gender sensitive and specific. Ensure that voices are heard at the ground and persons with psychosocial disabilities claim the space. Ensure that we not only know our rights but also living and advocating for these rights

Re-cap of the meeting The meeting was such a success as there were practical lessons which were learnt by different support groups All were in agreement that it was such a wonderful interactive session and very empowering.

A lot of gratitude was extended to USPKenya for organizing for the workshop and also to OSIEA for funding the project. The participants felt encouraged and empowered by this interactive session There was a recommendation on the need for more meetings of the support group leaders for the purpose of capacity building

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(support group leaders from the 4 counties during a networking session in Nairobi)

DISSEMINATION MEETING HELD ON 29TH JUNE, 2013, at Pearl Palace, Nairobi

The meeting was opened by Mr. Michael Njenga, head of programs, USPKenya, who welcomed all in attendance. The chairperson, Jane welcomed all and this was later followed by introductions. In attendance were, Hellen Obande Chief Executive Officer United Disabled Persons of Kenya, Annie Robb visiting guest from the Pan African Network for Persons with Psychosocial Disabilities (PANUSP) and Elizabeth Kamundia a human rights lawyer. The meeting was also attended by USPKenya board members, ordinary members and also journalists from different media station. Michael gave a history of USPKenya, on its work on advocacy, and of human rights of persons with psychosocial disabilities. He informed all in attendance that USPKenya had support groups in 4 Counties, with plans of extending to some other counties in the near future. It was also noted that USPKenya was involved in the following legislative processes: developing a suggestion paper on legal capacity, the legal aid bill, the mental health care bill and following up on the concluding observations made by the committee against torture

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There was emphasis for USPKenya to work with other DPOs, and hence the presence of Hellen, who would advice on how UDPK could collaborate with USPKenya. USPKenya integration Hellen began by noting that USPKenya was quite vocal in advocating for the rights of persons with psychosocial disabilities. She stated that UDPK works with 120 groups of persons with disabilities and since USPKenya was an organization that dealt with psychosocial disability issues, it was working with UDPK to attain the equalization of opportunities for persons with disabilities. UDPK was involved in developing a parallel report on the CRPD which was submitted after the Kenya state report. Kenya handed its report in April 2011 concerning CRPD implementation. Hellen highlighted the fact that the National Council for Persons With Disabilities was keenly promoting accessibility of services by persons with disabilities and also in empowering women with disabilities. She stated that UDPK was working on a criminal justice program targeting the police, courts, probation and prisons. A report had been launched by UDPK assessing how accessible the services were to persons with disabilities within the criminal justice system. UDPK had also developed modalities on training players in the criminal justice system on how to deal with persons with disabilities. This had been prompted by the need for accessible services in these departments. Hellen challenged USPKenya on the need to be integrated more in UDPKs activities and also in the cross disability movement.

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(Hellen Obande, CEO UDPK, during the public launch and dissemination forum)

Livelihood It was reported that UDPK had an economic empowerment program for persons with disabilities. This involved grants to engage in livelihood projects in order to generate income. The process involved identification of groups that can be supported with grants of between Ksh.50, 000 to 250,000, depending on the strength of the group. USPKenya members were encouraged to apply for these grants from UDPK . The UDPK CEO, concluded by stating that there were opportunities that the organization would benefit from by collaborating with UDPK, and all that was needed was for USPKenya to be claim their space in UDPK and also within the cross disability movement. The head of programs informed all in attendance that there was on-going documentation on the human rights violations of persons with psychosocial disabilities and this would help in highlighting the challenges faced by them in different spheres of life. He also highlighted on the many opportunities that women with disabilities could benefit from.

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(Annie Robb from the Panafrican network of persons with psychosocial disabilities making a presentation) She was next and she gave a brief history of the global advocacy initiatives whose motto is: Dignity, Autonomy, and well-being. In 1997, world network of users and survivors of psychiatry was formed and Africans were invited for the first time in 2004. Since then so much progress has been achieved culminating into the Capetown declaration of 16 Oct 2011 which was read at the meeting. However it was noted that much more needed to be done to strengthen the global voices of persons with psychosocial disabilities to promote their rights. One way of doing it would be to get audience with the UN rappouteur on persons with disabilities, and highlight the plight of persons with psychosocial disabilities in Kenya. She noted that human rights treaties are important and legally binding in international law and therefore any nation that had ratified the CRPD was bound to implement the content.

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Elizabeth Kamundia, a human rights lawyer, talked about law and human rights for persons with disabilities.

(Elizabeth Kamundia, a consultant with USPKenya ,making a presentation on Human Rights) She noted that it was not only important to have support groups in order to network and support one another but also human rights training was good. She drew attention to article 12 (legal capacity) of the CRPD. She emphasized that human rights are due to anyone by virtue of being human i.e human rights are inherent not alienable; are universal, interdependent and indivisible. A good example was given of the right to education, that everyone was entitled to education regardless of any disability. Right to health was also mentioned as not only the right to access health services, but also to the highest attainable level of both physical and mental health. It was however noted that it was one thing to have a right but another thing to claim and exercise the right. There was need to strongly advocate for rights as persons with psychosocial disabilities. Various groups had been discriminated before over a long time; but arising and agitating for their rights, had enabled them to counter discriminatory practices and human rights violations. Elizabeth concluded by highlighting that the human rights approach to disability focuses on eliminating environmental and attitudinal barriers that enables persons with disabilities to participate in the society on an equal basis with others. She stated that article 12, is at the heart of the convention because it restores power, voice and choice to persons with disabilities making them subjects of the law with equal rights and obligations but not objects to be managed and cared for by others. Michael concluded by emphasizing the need for self-advocacy as had been mentioned by previous speakers which will enhance the voices of persons with psychosocial disabilities. He observed that

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advocacy requires numbers and strategic relationships in order for it to be effective and successful . There was need for persons with psychosocial disabilities to register with NCPWDs in order to enjoy various benefits. An example was given of how a member of USPKenya had taken initiative and written to KRA to exempt her from tax as a person with disability. This had been rejected at first, but NCPWDs was following up the matter for her. There was literature about USPKenya that was disseminated at the meeting. The newsletters, bronchures and reports were shared with all in attendance.

LEGAL CAPACITY TRAINING

(Legal Capacity forum facilitated by Elizabeth Kamundia ) 29/07/2013

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Introduction USPKenya organized and facilitated training on legal capacity which targeted users/survivors of psychiatry together with their carers. The trainer, Elizabeth Kamundia, who is an advocate of the high court in Kenya, introduced the session by stating that all people are equal before the law, regardless of any disability. She explained that disability arises when a person who has impairment interacts with attitudinal and environmental factors which hinder their full and effective participation in the society on an equal basis with others. She emphasized on the importance of being empowered on legal capacity which is a right to self determination and autonomy. Objectives of the session To explore what Article 12 of CRPD states. To understand what legal capacity is in our local context.

What is legal capacity? Legal capacity is defined as the capacity to hold rights and to exercise them. Some questions were posed by the facilitator to those in attendance. As a person with a psychosocial disability, can you sell land? Can you get a loan on it? Article 12:3 states parties shall take appropriate measures to provide access by persons with disabilities to the support they may require in exercising their legal capacity It was noted that in most times, an individual exercised his/her legal capacity and attained independence being 18 years of age, in Kenya, but this was not so for persons with psychosocial disabilities. The Kenyan constitution still has a clause of persons with unsound mind. This discriminated persons with psychosocial disabilities in exercising their right to vote. It was noted that though there was the Persons with Disability Act 2003, persons with disabilities continued to be discriminated against, on the basis of their disability. It was noted that in America, persons with a hearing disability could drive but in Kenya one cannot drive on the presumption that he poses a danger to himself and other road users. In understanding legal capacity, this means that one has the capacity to hold rights and also to exercise these rights. Therefore there are two integral parts in understanding legal capacity which are the right to make a decision and the right to have the decision respected by others. An example was given on the right to receive medical treatment on the basis of free and informed consent other than forced treatment which is very traumatic for persons with psychosocial disabilities. A carer at the meeting was at this point quick to say that persons with psychosocial disabilities lacked cognitive ability to make a decision. At this juncture, the trainer stated that a person with a psychosocial

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disability could be supported in decision making as opposed to the widespread substituted decision making. She stated that the will and preference of the person with a psychosocial disability should be respected. She further added that a person with a psychosocial disability could be helped to write an advance directive, where he/she states how to be handled and by whom during a crisis, or when in a position unable to make concrete decisions. One of the participants shared his experience of how he had felt discriminated. He got this idea of raising awareness on psychosocial disabilities, in the village, together with his friends who also had a psychosocial disability. We went to a church, and after the church service, we were allowed some few minutes to talk about mental disability. We also told the congregation that we had a psychosocial disability and that despite the disability, it was important to treat persons with psychosocial disabilities with utmost respect. We also sensitized the congregation on how to care for persons with psychosocial disabilities and support them in decision making. It is after sharing this that I felt much discriminated because the pastor said that he wanted to pray for us, because we had the disability that needed to be cured. The congregation also got very sympathetic, though this was not what we were looking for. We were just raising awareness. I really opposed this because am sure other people in the congregation also had issues e.g HIV/AIDS and they were not being prayed for, so why persons with psychosocial disabilities? Therefore we find that to date persons with psychosocial disabilities continue to face discrimination. Another participant shared how she had been deprived of her legal capacity informally by her family members. There is this time that I was not feeling fine, and my family could tell that I was not okay. I had failed to take my medication because I had started having some side effects. So my family members decided to take me to hospital. This I did not mind as I knew it was for my own good. However, I told them that I did not want to go to Mathari mental hospital as I never liked it at all. As a government medical centre, and having been there before, I did not want to go there because of its dilapidated condition and poor hygiene. I kept telling my family members that I preferred Chiromo medical center, which was a private medical centre and well managed. I even told them that I had money to pay. But they did not listen to me; they still went ahead and took me to Mathari hospital. I felt very bad but there wasnt much I could do about it. At this point, the facilitator explained that persons with disabilities have the right to make their own choices and their will and preferences should be respected in every decision that they make. For a minor, one would make the decision for them, in their best interest and then explain later. More over for persons with psychosocial disability, it might be better to engage them while not in a crisis, and come up with strategies on how to support them during a crisis. It was noted that the core of being a person lay on the ability to make decisions and that decisions shape who we are hence the importance of self autonomy and determination. Approaching legal capacity

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The trainer highlighted how different countries approached legal capacity. In some countries, especially those in the West, there are people employed by the state to work with persons with psychosocial disabilities independent advocacy) especially for those without families. They initiate dialogue to ascertain the will and preferences of a person and if need be, communicate the preferences to third parties. In this model, communication with the person with a psychosocial disability is key; hence the importance to address the communication needs and support. There is need to look at a relationship model, improve our listening skills, in order to understand the will and preferences of a person which will help in the supported decision making process. Peer support; which is a relationship of equality is provided for in Article 12:3 (CRPD) which states that appropriate measures shall be taken to provide access by persons with disabilities to the support they may require in exercising their legal capacity. The personal Ombudsman model: This is a Swedish model which ranks very high in terms of a relational model. It involves highly skilled people who do outreach work. They are called personal ombudsmen who are employed by the state. They go to the place where a person with psychosocial disability is, be it home or in an institution, and they bond with the person. If the person with a psychosocial disability accepts to be represented by this personal ombudsman, they then are supported in decision making. The personal ombudsman does not take over the life of the person with the disability. They discuss issues and only supports in decision making. The participants noted that it was important to establish respite centres where persons with psychosocial disabilities are taken for a short time when in a crisis. This is a place where their trauma or distress would be addressed and also any support on decision making could be provided. Such centers could probably be run by other peers within their networks other than being taken to a psychiatric ward. Guardianship The issue of guardianship was also highlighted. The facilitator posed a question on who a guardian is. Most of the participants answered that it was one who takes care of another. The facilitator however clarified that a guardian was one whom the court decides would make decisions on behalf of the person with a disability. It is at this point that one with a guardian ceases to be a person before the law. The guardian make the decisions on behalf of the person with a disability. The guardian can either make all decisions for the person or can be appointed to make specific decisions. She however noted that guardianship in Kenya is very rare and informal. Self-advocacy This was seen as the best way to advocate for one to enjoy self autonomy and determination. A participant narrated how he had been taken to hospital and through the empowerment on self advocacy that he had received from USPKenya training, once at the hospital, he requested the doctor to

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give him some time to make a decision on whether he wanted medication or not. The doctor obliged to this and continued attending to other patients. Later after calming down he expressed his wish to be attended to. He said that that was a big difference as compared to before where he would have felt helpless at the hands of the doctor. It was therefore noted that empowering persons with psychosocial disabilities on their right to self autonomy and determination was a good strategy of restoring back their voice which will enable them to enjoy their human rights. Advance directive An advance directive was also seen as an ideal way of supported decision making . It was defined as a tool that allows one to plan in advance on how they would like to be treated if they were in a position where it is difficult to make a decision or even ascertain their will and preference. The family should respect this advance directive. An advance directive could for example state give me time to calm down like an hour or let so and so make the decision for me. Advance directives in Canada are legally binding agreements and India is also in the process of making it legal.

Group Discussion on Legal Capacity Article 12 of the CRPD In the second session of the legal capacity training, participants were divided into 3 groups. The groups were heterogeneous, each group consisting of users, survivors and carers. The following were the questions and the answers that the groups presented after an hour of discussion. Group 1 1. Independence a) What does independence mean to you/definition and examples of what you feel it means to be an independent person? Independence is the state of being self sufficient, self reliant b) Examples of what you feel it means to be an independent person Being free to make choices e.g work Free to manage ones affairs, e.g where to worship Freedom to take responsibility for your actions, not conflicting with others Independent person free to make decision eg spending money, time Value independence Completeness Easiness Economically empowered

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Gives you a chance to decide Feel human rights respected Able to exploit full potential

c) Do you value independence? Yes sometimes and at times no. In instances when not in a position to value independence is eg during mania episodes, although during the episodes, the advance directive and treatment plan come in handy d) How independent are you when it comes to making: i. Financial decisions? ii. Healthcare decisions? iii. Personal life decisions such as who to marry, vote for, etc i. Financial decision Most of the people in the group are independent in making their decisions. Health decision Most of the people in the group are independent in making their decisions, while not in a crisis, but during a crisis, others make decisions for them. Personal life decisions e.g. vote, marry

ii.

iii.

We make our life decisions although revelation of the illness hinders one from being accepted fully by most. About marriage, The law is discriminatory as it states grounds of divorce as one of the partners being of unsound mind. 2. Receiving help (in the first place, it is important to point out that this is not the opposite of independence) Are there areas of life in which you feel you need support? Yes a) What kind of support would you need? How would you like to be supported in making decisions? Health care and financial support For my wills and preferences to be respected

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b) From whom would you want this support? Family friends, government, NGOs, church 3. Protection a) Do you think there are areas of your life in which you need protection? Yes b) In which areas? What kind of protection would suit? Reducing stigma through community empowerment Treatment in hospital to be with respect and respect my human rights. Right to choose medication Respect for treatment plan or advance directive. Legal Family, employee In marriage, protection from domestic violence

4) Impediments to making own decisions

What barriers exist that prevent you from making your own decisions? Lack of awareness Legal incapacity Family members lack of information

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(USPKenya members during the group discussions) Group 2 1. Independence a) What does independence mean to you/definition and examples of what you feel it means to be an independent person It means to do what you want, set priorities, making decisions about your life. b) Do you value independence? A lot, it is a right of decision-making and defining our own destiny. c) How independent are you when it comes to making: i. ii. iii. i. ii. iii. Financial decisions? Healthcare decisions Personal life decisions such as who to marry, vote for, etc Financial decisions- around 70% Health care decisions-around 50% Personal life decisions such as who to marry, vote etc-100%

2. Receiving help (in the first place, it is important to point out that this is not the opposite of independence)

a) Are there areas of life in which you feel you need support? Are there decisions that you feel you need support in order to make? Yes depending on a situation. b) What kind of support would you need? How would you like to be supported in making decisions? Depending on the kind of decisions c) From whom would you want this support? Caregivers, government, institutions, peers 3. Protection a) Do you think there are areas of your life in which you need protection? In which areas? What kind of protection would suit?

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Areas we need protection Business, finance, operations Human rights abuse Employment e.g on remuneration Expression of ideas (victimization) Freedom of association Decisions to be respected in laws Freedom of worship.

4. Impediments to making own decisions

a) What barriers exist that prevent you from making your own decisions? Lack of financial stability making us to be dependent on other people Religion barriers Cultural patterns and beliefs e. on gender issues Lack of empowerment / capacity when making some decisions. Self stigma low esteem and lack of self awareness. Gender imbalance

Group 3 1. Independence a) What does independence mean to you/definition and examples of what you feel it means to be an independent person? Freedom to make your own decisions You are aware and know that you can make decision Know that people will respect those decisions That there is a legal framework to protect your decisions

b) Do you value independence? Yes c) How independent are you when it comes to making: i. ii. iii. i. Financial decisions? Healthcare decisions Personal life decisions such as who to marry, vote for, etc Financial barriers could lead to poor health care

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ii.

Attitudinal barriers, self stigma can affect personal life decisions such as who to marry

2. Receiving help (in the first place, it is important to point out that this is not the opposite of independence) a) Are there areas of life in which you feel you need support? Are there decisions that you feel you need support in order to make? Yes.

b) What kind of support would you need? How would you like to be supported in making decisions? To curb anxiety open office not a safe space To be understood by those around Emotional support Isolation in home as the stigma one entire homestead must be supported. c) From whom would you want this support? 3. Protection a) Do you think there are areas of your life in which you need protection? In which areas? What kind of protection would suit? Women need protection at mental health facilities against gender based violence. 4. Impediments to making own decisions a) What barriers exist that prevent you from making your own decisions? Discrimination in media council, workplace Health protection laws from government Stigma and discrimination From legally binding laws Informal system: family friends, support mechanism Formal system; support mechanism

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Conclusion In conclusion, the facilitator gave contacts for various organizations where one would go to seek legal advice in case of an infringement of their fundamental rights and freedoms. The following were the contacts given: Kenya National Commission on Human Rights (KNHCR) - 0722 425 644 OR 0733 780 000 National Gender and Equality Commission - 0733 780 000 The Ombudsman Office 254 20 2270 000 Kituo cha Sheria FIDA Federation of Kenya Women CRADLE The Children Foundation

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HOW THE MEDIA IN KENYA REPORTS ON DISABILITY, MENTAL HEALTH AND SUICIDE

A STUDY OF THREE NATIONAL DAILY NEWSPAPERS

FOREWORD ..................................................................................... 53
Definitions: .............................................................................................................................................. 54

ONE: INTRODUCTION ....................................................................... 55

1.1 Background ................................................................................................................................. 55

1.2. Media monitoring project ................................................................................................................ 55 1.2 Objectives of the Media monitoring project .................................................................................... 56 1.3 Methodology..................................................................................................................................... 56

CHAPTER TWO: SITUATION ANALYSIS AND CHALLENGES .................. 57

2.1. Psychosocial disability ...................................................................................................................... 57 2.2. Suicide and Mental Illness................................................................................................................ 58 2.3. Suicide and Physical Illness .............................................................................................................. 58

2.4 Key challenges faced by persons with psychosocial disability ...... 58

2.4.1 Marginalization of their voices at the community and national level ........................................... 58 2.4.2 Human rights violation within the community and institutional settings ..................................... 58 2.4.3. Archaic and outdated Mental Health Legislation ......................................................................... 58 2.4.4. Extreme Poverty............................................................................................................................ 59

CHAPTER 3: FINDINGS ...................................................................... 60

3.1. The Star ............................................................................................................................................ 60

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3.2. The Nation........................................................................................................................................ 60 3.2.1. Additional analysis .................................................................................................................... 60 3.3. Discussion......................................................................................................................................... 60 3.3.1. News reports/briefs as the majority ......................................................................................... 61 3.3.2. Features and opinion pieces as a recommended practice ....................................................... 61 3.4 Emerging themes from news reports on disability, mental health and suicide ............................... 61 3.4.1. Language use by media ............................................................................................................. 61 3.4.2. Violence: ................................................................................................................................... 62 3.4.3. Stigma and discrimination: ....................................................................................................... 62 3.4.4 Political participation ................................................................................................................. 62 3.4.5. Legal capacity ............................................................................................................................ 63 3.4.6. Legal reforms ............................................................................................................................ 63 3.4.7. Deplorable conditions in mental health institutions ................................................................ 63 3.4.8. Suicide ....................................................................................................................................... 64

Annex 1: Media monitoring Findings ................................................ 69

Annex 2. The Newspapers ...................................................................................................................... 76

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FOREWORD
The mass media is influential in shaping peoples knowledge, attitudes and behaviour. Our societys understanding of psychosocial disabilities is less than ideal and stigma and discrimination are not uncommon. The media is an important source of information about and for persons with psychosocial disabilities and for the general population. Reporting inaccurate information about psychosocial disability (e.g. linking mental health conditions with violence or using derogatory language in reference to persons with psychosocial disabilities) promotes stigma and perpetuates myths about mental disabilities within the wider community. Reporting on psychosocial disability (mental health conditions) is a relatively new area that fortunately is picking up in the media. Growing up in the 90s for most users of psychiatric services was a challenge as there was a dearth of knowledge on the same and psychiatry was a mostly alien area. It is for that reason one will get many users of these services that were often times misdiagnosed; for example because of heart palpitations, fever, tremors; anxiety and depression could be thought to be ailments such as malaria and typhoid and even chest infections. Schizophrenia, among the most severe forms of mental illness was taken as uendawazimu or madness thought to be brought about by supernatural causes and could not be managed hence the affected were left to loiter and wander away from home or bundled in mental institutions. To find information in the media about such was next to nil; as there wasnt even much research on these psychosocial disabil ities often then thought to afflict more the European as opposed to the African. The issue of suicide on the other hand is just starting to get highlighted in the media; although there are so many gaps in as far as tackling this sensitive issue in the media is concerned. Suicide is a taboo subject and most families opt not to discuss it as it is considered an abomination for someone to commit suicide. However, research keeps showing that there is an increasing link between mental health conditions and suicide and rising cases of suicide in our society also make it a topic to continuously highlight and seek ways to address it. Mass media campaigns (particularly if they include personalized stories) have shown some positive effects in as far as disability is concerned and how the general public treats and sees people that have disability. USPKenya desires to see a change in shift in reporting on matters of disability and suicide. The concentration has been too much on the disabilities; however we need to have at the centre of this reporting the persons themselves as opposed to their illnesses. What for example are barriers these people are encountering; why is there entrenched stigma in society directed towards people with disability and how are media reports helping to end the same. We hope this is a first step in a successful future to reporting positively and regularly reporting on matters of disability, mental health and suicide.

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Definitions: Feature story: A newspaper or magazine article or report of a person, event, an aspect of a major event, or the like, often quite lengthy. As opposed to news stories that are factual and straightforward, a feature story often has a writers personal slant and is written in an individual style. News story: An article reporting news; presented in a straightforward style. A news story concentrates on the facts as they present. Often not as lengthy as a feature story. Opinion piece: An article in a publication expressing the opinion of its editors or publishers. CRPD (Convention on the Rights of Persons with Disabilities): The CRPD is a United Nations Treaty, which is an express agreement under international law entered into freely by sovereign states (Kenya included) and international organizations to legally bind themselves to the principals, duties and obligations under the CRPD. It identifies the rights of persons with disabilities as well as the obligations on States parties to the Convention to promote, protect and ensure those rights. The CRPD is grounded in a broad human rights framework based on the United Nations Charter, the Universal Declaration of Human Rights, international covenants on human rights and other human rights instruments.

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ONE: INTRODUCTION 1.1 Background

Users and Survivors of Psychiatry in Kenya (USPKenya) is a non-governmental organization that was established and registered in Kenya in the year 2007. It is a membership organization whose major objective is to promote and advocate for the rights of persons with psychosocial disabilities (mental health problems) in Kenya to enable them live and work as productive members of society. Among USPKenyas objectives is to make use of public forums to give messages about mental health as a way of public education. Indeed, USPKenya has considerably for a number of years now involved itself in media engagements in efforts of public education. This is carried out through among other avenues appearances in diverse media, publishing newsletters, social media, brochures and other publications for the promotion of the objectives of the organization Over time, human rights of people with psychosocial disabilities have largely remained unaddressed and ignored in our society. They are chained, tied up, subjected to violence and maintained in appalling conditions, suffering extreme stigma and discrimination in many communities. Most often issues such as lack of access to justice, education, employment, the right to be included and participate in the community without discrimination and freedom from violence and abuse are overlooked. 1.2. Media monitoring project USPKenya has been working on a project on the human rights of persons with psychosocial disability in collaboration with the Disability Rights Initiative of the Open Society Foundation. It is under this project that USPKenya embarked on a media monitoring project targeting three daily national newspapers to identify how the media reports on issues of disability, mental health (and suicide. The newspapers targeted were the Nation Newspaper, The Star and The Standard.1 The media monitoring project would then guide USPKenya to identify best practices in reporting on these issues and communicate the same to media organizations in efforts to build relationships with the media and in essence promote objective, regular and sustained reporting in this area in order to stamp out the rampant stigma and stereotypes that come as a result of ignorance on such matters. The Media monitoring project targets the following outcomes: i. Increased capacity of the media to deliver their mandate in reporting on psychosocial disability (mental health) as a component of a person overall wellbeing; ii. Increased participation by the media in psychosocial disability and awareness through access to timely and accurate information;

See Annex 1

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iii. iv. v.

Increased exchange of information between users/survivors/ caregivers and media in efforts of regular and sustained reporting in disability, mental health and suicide; Improved policy and legislative environment for persons with psychosocial disability; Enjoyment of human rights as a result of increased awareness.

1.2 Objectives of the Media monitoring project The project aimed to achieve the following objectives: 1. To reflect on how the print media reports on disability, mental health and suicide; 2. To assess the quality of such reporting and determine areas that require improvement; and 3. To showcase best practices in reporting and share lessons learnt to inform on-going interventions. 1.3 Methodology Daily newspapers were analyzed from the month of April 2013 through to the month of June 20132. This research sought to find out how articles on disability, mental health and suicide are presented in the papers looking at: a) the angle of presentation taking into consideration the understanding of the matters at hand (which would then see how objective the article is written/does it propagate common stereotypes towards disability/ does it for instance in cases of suicide sensationalize the matter at hand/does it give the reader additional information for example where to seek help); b) the form the article takes (in terms of is it a news story, feature story, a brief mention); and the pages under which these articles are at (how conspicuous to the reader).

Analysis was also done on newspapers including The Nation and The Standard from October 2012 looking at select news stories to inform further this research.

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CHAPTER TWO: SITUATION ANALYSIS AND CHALLENGES Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.

physical, mental, intellectual or sensory

INTERACTION

BARRIERS

Environmental

IMPAIRMENT

hinder FULL AND EFFECTIVE PARTICIPATION in society

2.1. Psychosocial disability The preferred terminology of persons with psychosocial disabilities is used generally to refer to persons who may define themselves in various ways: as users/survivors of mental health services whether formal or informal services; people who experience mood swings, fear, voices or visions; people experiencing mental health problems, issues or crises. The term psychosocial disability is meant to express the following:

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 A social rather than medical model of conditions and experiences labelled as mental illness. A recognition that both internal and external factors in a persons life situation can affect a persons need for support or accommodation beyond the ordinary. 2.2. Suicide and Mental Illness Mental illness is a risk factor for suicide with reports indicating that nine out of 10 suicide cases have a mental illness. The mental illnesses most associated with suicide include depression, alcoholism, schizophrenia, and personality disorder. The leading cause of suicide is untreated depression which may be triggered by one or some of the factors discussed earlier. 2.3. Suicide and Physical Illness Chronic illnesses particularly those that are associated with stigma, a negative outcome, a lot of physical pain, disfiguration and debilitation are risk factors for suicide. The list of physical illnesses most commonly associated with suicide include HIV/AIDS, cancer, stroke, brain damage, spinal injury, diabetes and epilepsy.

2.4 Key challenges faced by persons with psychosocial disability 2.4.1 Marginalization of their voices at the community and national level Community level: Users/Survivors are not able to participate effectively within their community networks e.g. due to stigma and discrimination. They are also not well coordinated and empowered. National level: Exclusion from legislative processes, poor representation within government structures, lack of political goodwill 2.4.2 Human rights violation within the community and institutional settings Community setting: Verbal, physical, sexual abuse, deprivation of liberty (chaining and being locked up). Inaccessibility of health services that are affordable, acceptable, accessible and appropriate. Institutional setting: Abuse (physical and verbal) from the professionals (nurses, doctors and support staff) and fellow patients. Forced treatment and the use of medical interventions without free and informed consent. 2.4.3. Archaic and outdated Mental Health Legislation Current drafts are versions of draft template laws introduced by World Health Organization at the start of the century before the Convention on the Rights of Persons with Disability (CRPD) was adopted. This

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template is an improved version of archaic laws often dating back to the turn of the 20th Century. They do not however embody the paradigm shift required by the CRPD.

2.4.4. Extreme Poverty Users/Survivors in our communities live in deplorable and degrading conditions due to extreme poverty. This is aggravated by the following factors: Social exclusion from family, friends and society in general Lack of social support from the State e.g. social protection, cash transfer programs Limited education and employment opportunities Lack of sustainable livelihoods

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CHAPTER 3: FINDINGS

In the three months; there were a total of 107 items that had reported on disability; mental health and suicide. 3.1. The Star The Star had 59 articles (approximately 55%) while Nation had 48 articles (approximately 45%). Of The Stars 59 articles, 24 (41%) are articles that are news reports on suicide 26 (44%) articles are reports on disability 9 (15) articles are reports that mention mental health/illness Of The Stars 59 articles, 55(93%) are presented as news stories/briefs 3 (5%) as feature stories 1 (2%) as an opinion piec 3.2. The Nation Of The Nations 48 articles, 15 (31%) are articles that are news reports on suicide 8 (17%) report on disability 16 (33%) articles are news reports that mention mental health/illness NB. Not included herein is a regular column by a psychiatrist, Dr. Lukoye Atwoli, who writes every Sunday; he does write about mental health, but not entirely on it as a number of times he may write about health in general/ or even write topical commentaries. Of The Nations 48 articles, 26(54%) are presented as news stories/briefs 9 (19%) as feature stories 10 (21%) as opinion pieces

3.2.1. Additional analysis On the analysis that was done on newspapers (The Nation and The Standard) from October 2012 through to December 2012 to further inform the research, the following were the findings: 19 articles had reported on the research areas of disability, suicide and mental health. 7 (37%) reported on suicide as news briefs. 10 (53%) were reports on mental health whereas 2 (10%) reported on the issue of disability. 3.3. Discussion

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3.3.1. News reports/briefs as the majority News reports/ often appearing as brief reports of the event are not in depth articles and they are the majority from our report; hence in many stories running in our newspapers, there is a failure to include advice, information and counselling contacts for readers especially on reports on suicide. It is worthwhile to note that with so many suicide reports coming as news briefs; there is no in-depth feature on suicides (in the three months) which would be a recommended practice. 3.3.2. Features and opinion pieces as a recommended practice In the feature stories running in the newspapers; it was noted that a lot of thought has been put into research as would be expected of a story running through two pages. Only that they are not as many as the news reports. This is commendable more so from The Nation newspaper as it had 19% feature stories as opposed to The Stars 3%. The beauty of feature stories is that they have a lot of depth; and the importance of opinion pieces is that they come with authority as they are written by experts in the said areas and this can have a lot of impact on policy and legislation. The weekly column in the Nation by Lukoye Atwoli, a psychiatrist, and secretary, Kenya Psychiatric Association is a commendable step by a Daily newspaper however we note that the writer does not always write on purely psychiatric/mental health or health issues; he often times writes political commentaries however this is a good platform from a national daily to highlight on mental health and its related topics. The Nation has also dedicated space to address mental health issues more so in its DN2 pull out and magazines where we were able to see discussions on schizophrenia and bipolar disorders; autism, ADHD all this adding depth into the knowledge of the reader on such matters. 3.4 Emerging themes from news reports on disability, mental health and suicide 3.4.1. Language use by media Article 54 (1) states that: A person with any disability is entitled to be treated with dignity and respect and to be addressed and referred to in a manner that is not demeaning. From this research we noted several instances when the media did not put this into practice. Case 1: After patients walked out of the Mathari hospital; we noted a lot of stigma perpetuated by the media; probably as a result of ignorance on matters of mental health which went to show the stigma with which mental health is treated. Words used included inmates breakout police which almost made it seem like these were criminals who were breaking out of a prison. Two television stations actually presented the news as something to be made fun of; while a comedy programme in one of the TV stations went as far as making fun of the whole story. Case II: The headline Wambui Otienos widower says she was mad when she wrote will. Such headlines are not common; the reason would be that actually we do not have many of these stories; however,

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many stories when necessary have used the words mentally ill which is advised as opposed to the stigmatizing and demeaning mad. 3.4.2. Violence: Article 29 of the Constitution on freedom and security of the person provides that every person has the right to freedom and security of the person which includes the right not to be subjected to any form of violence from either public or private sources. Persons with psychosocial disabilities are subjected to abuse and violence more so within their family and community set up. Indeed, news stories under the media monitoring project show the meting of violence on persons with psychosocial disability more so gender-based violence; an area that has seen such people not enjoying their human rights contrary to provisions in the Constitution. The Nation, on April 22, 2013 carried an in depth feature of a mentally ill woman who gave birth to twin girls after being raped on the streets. The Standard on 8th November 2012 carried a story of a 12 year old girl with mental illness who was admitted at Kitale District Hospital following a sex assault. 3.4.3. Stigma and discrimination: Psychosocial disabilities are among the most stigmatized disabilities in Kenya. Unlike other types of disabilities, strong social, religious and cultural stigma is associated with psychosocial disabilities. In many communities mental illnesses are associated with witchcraft, spiritualism and curses. Parents and caregivers of those living with severe and profound psychosocial disabilities also fear open association with this stigmatized disability. On June 10, 2013, The Nation carried a news report titled Stigma against persons with disabilities rife in Meru. A church leader noted that lack of understanding and misconceptions are still fuelling stigma against persons with disabilities. On 17th April 2013 The Star had a report on the Ministry of Education warning parents and teachers against discriminating disabled children by hiding them. April 19th 2013, The Star also reported that the Kenya Society for the Deaf had decried the increasing discrimination of children with disabilities leading to stigmatization urging that children with disabilities should be incorporated in all spheres of society. 3.4.4 Political participation Chapter 54 (2) of the Constitution states that: The state shall ensure the progressive implementation of the Principle that at least 5 per cent of the public in elective and appointive bodies are persons with disabilities. Most articles on disability show persons with disabilities and lobby groups are advocating not to be left out of the political process as provided by the Constitution.

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In an article in The Star on April 13/14, the National Council for Persons with Disabilities asked the President and his deputy to appoint persons with disability to the cabinet. 3.4.5. Legal capacity Legal capacity means a capacity to have rights and the power to exercise those rights. Practically, legal capacity is the laws recognition of the validity of a persons choices. It protects the dignity of persons as well as their autonomy their ability to take charge of their own lives and to make their own decisions. These decisions span a broad range including the development of personal relationships, medical treatment, finance and asset management. Persons with disabilities should enjoy their legal capacity on an equal basis with others. On June, 28th, 2013, The Star Newspaper had a story titled, Mum tries to get back baby from marketer. In this story a 21 year old woman was suing her boyfriend for the return of her baby son who was taken from her just four days after she gave birth on April 23rd, simply because the doctors had diagnosed her as suffering from post-natal psychosis. On May 11th 2013 The Star Newspaper ran a story on Wambui Otieno, a renowned freedom fighter who had on previous occasions been featured in the media. Her widower was contesting her will on the basis that she was not mentally well when she wrote the will. The deceased did not have the necessary mental capacity to know what she was doing at the time of making the will due to her illness. (NB. Art. 12 of the CRPD has midwifed a significant paradigm shift for the way in which persons with disabilities exercise their human rights. The assumption before was that persons with disabilities did not have legal capacity. The assumption now is that all persons with disabilities have legal capacity and that wherever they may not be able to exercise that capacity effectively they shall be provided with appropriate support to make their own decisions.) 3.4.6. Legal reforms MPs with various disabilities launched a disability caucus - Kenya Disability Parliamentary Caucus (Kedipa) through which they are legislating laws in favour of persons with disabilities. The Star Newspaper reports more here: http://www.the-star.co.ke/news/article-123698/mps-fight-rightsdisabled#sthash.r6yFnrE5.dpuf USPKenya is part of a reference group that is currently engaging with Kedipa in efforts that are spearheaded by the cross disability movement. The Daily Nation on April 3rd 2013 had an item on Senator to push for law that will help the disabled' reporting on efforts by a nominated Senator who is a person with disability in his efforts to lobby county assemblies to set up a social protection policy for persons with disability. 3.4.7. Deplorable conditions in mental health institutions Article 28 of the Constitution of Kenya (CoK) on human dignity provides that Every person has inherent dignity and the right to have that dignity respected and protected. Article 29 (d) and (f) of the CoK state that Every person has the right to freedom and security of the person which includes the right not to be

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subjected to torture in any manner whether physical or psychological and and be treated or punished in a cruel, inhumane or degrading manner. On the Daily Nation in the month of May 2013 there was a commentary on Mathari Hospital calling on the government and Kenyans at large to boost care for persons with mental illness in the country. The commentary also highlighted the deplorable conditions at the hospital. http://www.nation.co.ke/oped/Opinion/Society-should-stop-neglect-of-mental-patients//440808/1856658/-/13mq44jz/-/index.html In a separate article in The Nation, a feature article titled Inside Kenyas most depraved hospital highlighted the appalling conditions in Mathari Hospital where the patients and staff told the reporter tales of hunger, abandonment, disease, sexual abuse and torture and also highlighted the fact that torture of mental patients is rampant in the country. http://eastandard.net/inside-kenyas-mostdepraved-hospital/ 3.4.8. Suicide Suicide is an emerging problem in our society that needs to be addressed. We have adapted strategies from Samaritans3 that reporters would find worthwhile when reporting on suicide. Provide contact information for support services, to encourage people at risk to seek help at an earlier stage. Raise awareness of the complexity of the issues surrounding suicide Avoid explicit or technical details of suicide in reports

Providing details of the mechanism and procedure used to carry out a suicide may lead to the imitation of suicidal behaviour by other people at risk. For example, reference can be given to an overdose but not reference to the specific type and number of tablets used. Similarly, saying someone "hanged themselves" is better than saying they "hanged themselves using their own school shirt from their bedroom door". On Tuesday, 6th November 2012 for example, The Standard had this sentence on a suicide report: is said to have died after taking a chemical used to spray tobacco

Avoid simplistic explanations for suicide

Although a catalyst may appear to be obvious, suicide is never the result of a single factor or event and is likely to have several inter-related causes. Accounts which try to explain a suicide on the basis of a

The Samaritans are a charity, founded in 1953, which exists to provide confidential emotional support to any person, who is suicidal or despairing; and to increase public awareness of issues around suicide and depression.
3

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single incident, for example unrequited romantic feelings, should be challenged. Where relevant, news features could be used to provide more detailed analysis of the reasons behind the rise in suicides. The Star, on April 4th headlined a report on suicide thus: Bomet teacher hangs self after wife walks out.

Avoid disclosing the contents of any suicide note

This information may sensationalise the suicide. It may also provide information which encourages other people to identify with the deceased. On April 4th in The Star Newspaper, a report on a suicide revealed the content of a suicide note which read, I am sorry. I cannot live with you but what I know is that I love you and I do not want to kill you but let me take my life so that you will know that I love you.

Encourage public understanding of the complexity of suicide

People dont decide to take their own life in response to a single event, however painful that event may be, and social conditions alone cannot explain suicide either. The reasons an individual takes their own life are manifold, and suicide should not be portrayed as the inevitable outcome of serious personal problems. Discussing the risk factors encourages a better understanding of suicide as part of a much wider issue and challenge for society. Additionally, communities should be educated on identifying signs of distress in their midst for purposes of providing appropriate support and intervention. E.g. In a story in the Daily Nation, on April 18 th, 2013, where a teenager boy brought two photographs of himself on a Monday and told his mother that they should be placed on his casket. The boy later took his life on Wednesday of the same week.

Consider the timing

The coincidental deaths by suicide of two or more people make the story more topical and newsworthy, but additional care is required in the reporting of another suicide, just days after, which might imply a connection.

Include details of further sources of information and advice

Listing appropriate sources of local and national help or support at the end of an article or a programme shows the person who might be feeling suicidal that they are not alone and that they have the opportunity to make positive choices. Criminalization of suicide:

Suicide is categorized as a criminal offence in Kenya. There is a need to address this issue as it is not prudent to criminalize social issues more so when a person is experiencing distress or is in a crisis. Instead the law should provide for the relevant support and interventions that might be needed by such a person. For example, in April 9th, The Star newspaper reported on Kelvin Kahuhia who had been

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charged with trying to drown himself in the Indian Ocean. This was despite the fact that his father defended him in court by saying he had a history of mental health problems especially when faced with challenges. Kahuhia was a top performer in a secondary school but fell into depression when he failed his 2012 KCSE examination. The court released him on a Ksh. 10,000 personal bond and set a later date for sentencing.

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Chapter 4: Conclusions and Recommendations Persons with psychosocial disability play a critical role in increasing awareness and reducing stigma and discrimination. These efforts can be harnessed by working closely and positively with the media and other relevant stakeholders. USPKenya hopes that this pioneer media monitoring project will go a long way to ensure that the issues of persons with psychosocial disability, suicide and mental health are properly highlighted and addressed within the mainstream media It is USPKenyas hope that the following recommendations can inform and guide the undertakings of various stakeholders but most importantly the media in the area of disability, suicide and mental health. 1. There is a need for disability rights activists, mental health professionals and the media to work together to encourage in depth and regular reporting in the area of psychosocial disability, mental health and suicide. 2. There is need for the media to interact more with persons with psychosocial disability (Users/Survivors) who, as experts by experience have insightful perspectives and can act as drivers of social change. This will go far in reducing the stereotypes, ignorance, stigma and discrimination that is associated with mental health conditions. 3. There is critical need for a national suicide policy that would among other things embrace holding national awareness campaigns on the issue of suicide and having support systems/ hotlines on suicide for individuals in crisis. 4. There is need for the media to focus more on voices of the persons with psychosocial disability whereby there would highlight more on psychosocial disability as a social problem as opposed to a medical problem hence most solutions will always come from the communities and families hence emphasis on community mental health. 5. There is need for the media to focus on the human rights violations that are perpetuated against persons with mental health problems within mental health institutions and also within their families/communities. This includes sensitizing families on human rights of persons with psychosocial disability more so in relation to gender based violence. 6. In line with Art 54 (1) a of the Constitution of Kenya 2010 which states A person with any disability is entitled to be treated with dignity and respect and to be addressed and referred to in a manner that is not demeaning it is important that the media, in fulfilling this constitutional obligation to adopt a sensitive approach while reporting on issues of psychosocial disability, mental health and suicide.

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7. There is critical need on integration of peer support as part of overall mental health policy within the devolved government structure. Such support should also be rendered to families and communities e.g. the establishment of respite centres that can assist the needs of those affected when in a crisis. 8. Disabled persons organizations and their counterparts in the area of mental health need to engage with the media council in enhancing sensitive and accurate reporting.

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Annex 1: Media monitoring Findings April: The Star Headline 1. 2. 3. 4. 5. 6. 7. Embu man hangs self over smashed cell phone Disabled demand county positions Bomet teacher hangs self after wife walks out Student kills self over poor school grades Mentally ill boy drowns in dam Man hangs self at council offices Date April 2. 2013 April 2. 2013 April 4. 2013 April 8. 2013 April 9. 2013 April 10. 2013 Type of article/page # News story #9 News story #2 News story #14 News story #11 News story #9 News story #9 News story #8

Kitui man arrested for bewitching dad to April 11. 2013 death Nakuru man kills wife, flops in suicide attempt Give us cabinet slot, disabled ask Uhuru April 12. 2013 April 13/14. 2013 April 17. 2013 April 17. 2013 April 19. 2013 April 19. 2013

8. 9.

News story #17 News story #10 News in brief #15 News story #16 News in brief #21 News in brief #23 News story #3

10. Two die in hotel room suicide 11. Ministry warns over disabled children 12. Deaf society slams stigma 13. Disabled union asks for Sh2b

14. Standing ovation for special needs students April 20/21. 2013 performance

15. Bungoma disabled want posts in county 16. Disabled ask for positions 17. Sh.11.4m for the disabled in Nakuru 18. Nakuru mum sets children, self on fire April: The Nation

April 20/21. 2013 April 25. 2013 April 25. 2013 April 30. 2013

News story #16 News story #11 News story #14 News story #15

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Headline 1. 2. Police probe death of teacher in house

Date April 1. 2013

Type of article/ page # Briefs #18 Briefs #17

School principal found hanging; man in custody after April 1. 2013 wifes killing; Mason reportedly poisons himself Man hangs himself over Raila petition loss April 2. 2013

3.

News article #10 4. Overcoming the fear of epilepsy April 2. 2013 DN2 Feature story/page spread Briefs#19 Briefs#10 Opinion #36 Briefs#35 Press release#27

5. 6. 7. 8. 9.

Senator to push for law that will help disabled Teenager girl kills self after quarrel with lover An open letter to the incoming president Parents disown child born with albinism

April 3. 2013 April 6. 2013 April 7. 2013 April 12. 2013

Message to our leaders from the United Disabled April 18. 2013 Persons of Kenya Family in shock as teen found hanging April 18. 2013

10 11

Briefs#35 DN2 news feature

A mentally ill woman that was gang raped, pregnant April 22. 2013 and abandoned Fight for rights of the disabled, urges lobby Monitor your childs mental health Nominate disabled too, Uhuru urged Familys fiery deaths shock village pastor Can doctors detect autism in my unborn baby? April 23. 2013 April 23. 2013 April 27. 2013 April 30. 2013 April 30. 2013

12 13 14 15 16

Briefs#6 DN2 1 page Feature News item#5 News item#8 DN2 Feature

May: The Star Headline 1 Blind farmer inspires others with his crops Date May 2. 2013 Type of article/page# Feature#9

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2 3 4 5 6

Kitui man kills his 10 month old son Woman kills self after husband remarries Embu man hangs self Man commits suicide in Imenti Wambui Otienos widower says she was mad when she wrote will Man in hospital for suicide plot Kiambu disabled street beggars to be arrested-DC Links growing between HIV and disability

May 6. 2013 May 7. 2013 May 8. 2013 May 10. 2013

News story News story News story News story News story

May 11/12. 2013 May 14. 2013 May 14. 2013 May 15. 2013 Briefs News story Opinion News story

7 8 9 10

Runyenjes casual labourer, 50, commits suicide in May 15. 2013 Embu Against all odds; young people living with mental May 16. 2013 illness Lab technician poisons himself Mangu woman drowns four children and herself Fund mental health care, says Kimosop Nakuru holds autism walk Albino mum of two in fear of rejection Give the disabled more jobs, legislators Watamu man kills himself Disabled people fight for county assembly seats May 17. 2013 May 17. 2013 May 17. 2013 May 20. 2013 May 23. 2013 May 23. 2013 May 24. 2013 May 29. 2013

11

Feature page spread

12 13 14 15 16 17 18 19

Briefs News story News story News story News story News story Briefs News story

May: The Nation Headline 1 2 Boy dies after taking poison from mother What do I do if my child convulses Date May 1. 2013 May 7. 2013 Type of article Briefs Medical piece

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3 4 5 6 7 8 9 10 11 12

Spouse kills self after accusing wife of adultery Priest accused of rape found dead in house 14 patients return to Mathari demons disrupt classes at school Explain Mathari escape Society should stop neglect of mental patients Mental patients: media could have done better Inside Kenyas most depraved hospital Teachers body found hanging in his house Bipolar Disorder ;Understand it better

May 8. 2013 May 9. 2013 May 15. 2013 May 15. 2013 May 16. 2013 May 19. 2013 May 19. 2013 May 24. 2013 May 28. 2013 May 29. 2013 Briefs Editorial opinion Opinion Opinion News feature Briefs medical article Briefs

13

Improved health for Kenyans essential to realizing May 31. 2013 the vision 2030 objectives

Opinion

June: The Star Headline 1 2 3 4 5 6 7 8 9 10 An exciting event for the disabled in Mombasa Embu man commits suicide Man kills wife, hangs himself Fears over Meru suicides Sh85m for the disabled Actress Jiah Khan commits suicide Union wants blind people protected Pupils treated for hysteria Mps to fight for rights of disabled The circle of depression Date June 3. 2013 June 4. 2013 June 5. 2013 June 5. 2013 June 7. 2013 June 6. 2013 June 10. 2013 June 10. 2013 June 10. 2013 June 12. 2013 Type of article News story News story Briefs Briefs Briefs News story News story News briefs News story Opinion

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11 12 13 14

Jiah Khans suicide mystery continues Embrace people with disabilities, First lady Disabled want recognition

June 13. 2013 June 15/16. 2013 June 17. 2013

Entertainment news News brief Briefs Feature article one page

Blind scholar in Eldoret is an inspiration to June 19. 2013 many Albinos demand laws against discrimination Lobbyists fear for lives in disability funds saga Embu woman found dead MP roots for disabled Hysteria attacks are normal, says Knut Embu man, 50 kills himself Mum tries to get back baby from marketer Bondo DO hangs herself June 20. 2013 June 20. 2013 June 22/23. 2013 June 25 2013 June 25 2013 June 25 2013 June 28 2013 June 29/30. 2013

15 16 17 18 19 20 21 22

News story News story News brief News brief News brief Briefs News item Briefs

June: The Nation Headline 1 Date Type of article

Villager dies after mentally unstable kin hits June 1. 2013 him with axe at mothers home We must become our brothers keepers again Lovelorn guard stabs schoolgirl to death June 2. 2013 June 3. 2013 Opinion Briefs News item

2 3 4

Three commit suicide as county boss raises June 3. 2013 alarm There is no link between vaccine and autism Schizophrenia; that voice in the head We are a traumatized nation in need of healing Wife kills self days after mans suicide Stigma against persons with disabilities rife June 4. 2013 June 5. 2013 June 9. 2013 June 10. 2013 June 10. 2013

5 6 7 8 9

Opinion Medical article Opinion News item Briefly

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10 11 12 13

Wife finds man dead in suspected suicides Students suffer hysteria Indiscipline linked to rise in police deaths

June 2013 June 11. 2013 June. 2013 News briefs

Albinos to receive monthly stipend from June. 2013 government Tax exemption bid for the disabled praised Villager commits suicide by hanging State must fulfill mental health pledges Adolescents and depression I have schizophrenia but live a full life June 17. 2013 June 21. 2013 June 23. 2013 June 25 2013 June 26. 2013 Briefs Briefs Opinion Medical piece Life experience Opinion

14 15 16 17 18 19

More people with mental illness need to speak June 30. 2013 out

Select articles from October 2012 to January 2013 in The Nation and The Standard 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Shock as student commits suicide Man hangs self over financial woes Woman takes life over upkeep cash Intoxicated man bites off, swallows own finger Mentally ill minor attacked, assaulted Ten year old boy commits suicide Teacher kills self in parents home Why people get addicted Why murderous dads slaughter their children Ex-convict using musical talent to fight drug abuse Suicide-man hammers the wrong wife Nov 8th 2012 (S) Nov 11. 2012 (N) Nov 14. 2012 (S) Nov 13. 2012 (S) Nov 13. 2012 (S) Nov 9. 2012 (S) Nov. 16. 2012 (S) Nov.20. 2012 (S) Nov. 6th. 2012 (S) News brief News brief News brief News brief News brief News brief News brief Medical feature Feature Feature

11.

Nov. 5. 2012 (S)

Crazy Monday humorous article

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12. 13. 14. 15. 16. 17.

Stress during pregnancy may lead to depression Nov 3. 2012 (N) Shock as man hacks teenage son to death Form One student commits suicide Mentally ill man strangles son, kills self Girlfriend had to take knife from my hands Scott was on Drugs Oct 31 2012 (S) Oct 30th 2012 (S) Oct 29th 2012 (S) Oct 29th 2012 (N) Oct 26th 2012 (N)

News brief News item News brief News brief News brief News brief/entertainment Opinion

18.

The great depression and Kenyas mad Oct 24th 2012 (S) generation College grants plans for disabled students Oct 24th 2012 (N)

19.

News brief

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Annex 2. The Newspapers The Daily Nation Newspaper The Daily Nation is a national daily newspaper in Kenya. It has print as well as electronic media and digital platforms. The Star Newspaper The Star was launched in July 2007 as the Nairobi Star, a 32 page tabloid style newspaper concentrating on human interest stories in Nairobi and Kenya. In 2008 the paper switched to a more political general news format The Standard Newspaper The Standard is a national daily newspaper in Kenya. It has print as well as electronic media and digital platforms. Press Release
Kangemi P.C.E.A Church compound (Off Waiyaki Way) P.O. Box 10071 00100 Nairobi Kenya Tel. No.: +254 722 884 565 Website: www.uspkenya.com Email: info@uspkenya.com

21-Aug-2013 Spotlight on media reporting on disability, suicide and mental health in Kenya Suicide is an emerging problem in our society that cannot be ignored any more. There is need for the government to have in place a national Suicide Prevention Guideline. Findings of a three month media monitoring project by Users and Survivors of Psychiatry in Kenya into how the Kenyan media reports on issues of disability, mental health and suicide show that the area of suicide is treated with little significance. For the 39 cases of suicide captured in the newspapers; no effort has been made from any stakeholders to address this issue. All 39 cases are presented as short news briefs. Additionally, there is a failure to include advice, information and counselling contacts for readers especially on reports on suicide. In the three months; there were a total of 107 items that had reported on disability; mental health and suicide. Suicide is a criminal act in Kenya; a disturbing account which continues to increase the stigma surrounding it. There is fear and shame in suicide yet research keeps showing that there is an increasing link between mental health conditions and suicide.

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It is not right that in suicide attempts, the first people called are police officers. Such should not be the case, an attempt at suicide is a cry for help and a hospital should be the first point of referral, said Michael Njenga, Head of Programs at USPKenya. In USPKenya alone, we have evidenced how mental health conditions are a risk factor for suicide and how professional help, open dialogue among peers and good support systems on the same have in a number of cases acted as a stoppage to a suicide attempt, he added. On the other hand, reporting on psychosocial disability (mental health conditions) is a relatively new area that fortunately is picking up in the media as can be attested from the media monitoring report. Growing up in the 90s for most users of psychiatric services was a challenge as there was a dearth of knowledge on the same and psychiatry was a mostly alien area. It is for that reason one will get many users of these services that were often times misdiagnosed; for example because of heart palpitations, fever, tremors; anxiety and depression could be thought to be ailments such as malaria and typhoid and even chest infections. Reporting inaccurate information about psychosocial disability (e.g. linking mental health conditions with violence or using derogatory language in reference to persons with psychosocial disabilities) promotes stigma and perpetuates myths about mental disabilities within the wider community. Mass media campaigns (particularly if they include personalized stories) have shown some positive effects in as far as disability is concerned and how the general public treats and sees people that have disability.

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