USPKenya Submission CSC - UK 27jan2014 Revised

Kangemi P.C.E.
A Church compound (Off Waiyaki Way)

P.O. Box 10071 00100
Nairobi Kenya
Tel. No.: +254 722 884565
Email: info@uspkenya.com
Website: www.uspkenya.com
Users and Survivors of Psychiatry in Kenya

CEOs
Office
Mobile: +254 723664177 Email: kanyi.gikonyo@uspkenya.com Website: www.uspkenya.com
USPKENYA REGISTERED IN 2007 UNDER NGO COORDINATION BOARD REGISTRATION NUMBER OP. 218/051/2007/0456/4848

27
TH
JANUARY 2014
Page 1 of 6

MEMORANDUM SUBMISSION ON DISABILITY AND DEVELOPMENT FOR THE COMMONS
SELECT COMMITTEE (CSC) REGARDING THE UK DEPARTMENT FOR INTERNATIONAL
DEVELOPMENT (DFID)

1. Users and Survivors of Psychiatry in Kenya (USP-K) is a Non-Governmental Organization
(NGO) that was duly registered under the laws of Kenya on the 6
th
December 2007. It is
informally known as USPKenya

2. USPKenya is the only user/survivor organization in Kenya that is peer-led and peer-run
by persons affected by mental health conditions (also identified as persons with
psychosocial disability) and their families (Carers). USPKenya has three strategic areas
of focus:
a. Advocacy / Public Education and Awareness Creation through self-advocacy
b. Participation in Legislation and policy issues that affect the marginalized and
vulnerable group of persons with psychosocial disability guided by the general
principles of the Convention on Rights for Persons with Disability (CRPD)
c. Peer Support Group Initiative (Experts-by-Experience) that currently runs in 4 of
the 47 counties in Kenya

3. USPKenya is aware of DFID presence and operation in Kenya of which health is one of
the core areas of focus. We have not engaged DFID in any way either for funding or
technical support because we have not found any points of synergy between the work
we do in Mental Health and the focus of DFID Programs or Initiatives in Kenya as
described in point (4) below.

4. To the best of our knowledge and recent enquiries, the key areas of focus by DFID in
Kenya are as follows:
a. improving maternal and reproductive health
b. accelerating the fight against malaria
c. increasing school access and the quality of education
d. reducing vulnerability and malnutrition among Kenyas most disadvantaged
e. supporting refugees, improving governance and accountability
f. catalysing private sector growth to create more jobs for young people
g. helping Kenya to develop green energy and adapt to a changing climate

Kangemi P.C.E.A Church compound (Off Waiyaki Way)
P.O. Box 10071 00100
Nairobi Kenya
Tel. No.: +254 722 884565

CEOs
Office

Page 2 of 6

5. Further to point (4) above, the DFID Kenya Operational Plan 2011-2015 last updated
June 2013, there is no mention of Mental Health and/or Disability issues as areas that
DFID would like to partner with the Civil Society on to achieve specific or general
objectives and milestones.

6. It is worth noting that to the best of our knowledge with reference to the online
Development Tracker tool, there is a project on mental health that was conducted in
Kenya between 29
th
August 2008 and 31
st
March 2011, titled Respecting the Rights &
Needs of Mentally Ill People CSCF450 [GB-1-114054] with an approved budget and
obligation to fund GBP 275,034. project was funded centrally from London.

7. As per point (4) and (5) above with the exception of point (6) DFID programs are
inaccessible to persons with mental health conditions or psychosocial disabilities in
Kenya.

8. To the best of our knowledge, we are not aware of any programs from World Bank and ,
USAID that cater for persons with mental health conditions or psychosocial disability.
AUSAID has a global focus on health and disability. It is important to note that the
disability section of programs has not been extended to Kenya. Mental Health is not an
area of focus on their health agenda. There was an EU project titled Strengthening the
Capacity of People with Mental Disorders to hold Government to account for Mental
Health and Development in Kenya. The project period, ran from 01
st
February 2009 to
31
st
January 2012.

9. USPKenya has received support from:
a. The Wellcome Trust through Prof. Vikram Patel who was the Project Lead for
EMPOWER (Empowering people with Mental Disorders to PrOmote Wider
Engagement with Research) Project. The objective of the EMPOWER project was
to strengthen the capacity of user organizations in sub-Saharan Africa and South
Asia to utilise research findings to develop a plan for engagement with the
communities they work with to improve the understanding of the nature and
treatment of mental disorders and reduce the stigma associated with them.
b. The Open Society Foundation(George Soros Foundation) under the Disability
Rights Initiative (DRI) has supported a 1 year grant that ended last year and an
on-going project for another 1.5 years on Enhancing the Rights of Persons with
Psychosocial Disability Particularly. They have provided technical, capacity
building, training and financial support to advance the work on the marginalized
community of persons with psychosocial disability.

P.O. Box 10071 00100
Nairobi Kenya
Tel. No.: +254 722 884565

CEOs
Office

Page 3 of 6

Recommendations
10. DFID could have a two-prong approach to the mental health and psychosocial disability
(two sides of the same coin)
a. Mental Health Approach
i. Facilitate Access to Mental Health Services
Support advocacy initiatives to lobby theKenya Government to
increase funding/investment in mental health or supplement
development funding to provide effective psychotropic
medication in the Public Hospitals and into the clinics in the
community
Support the civil society with grassroot support to implement
projects that increase access to mental health services
Donation of basic but effective psychotropic medication especially
for the poor communities through the hospitals and clinics
Offer scholarships and incentives for students in universities who
elect to study psychiatry i.e. doctors and nurses. This will help to
increase the number of practitioners. We have an estimated 79
psychiatrists and 450 psychiatric nurses for a population of 41
million Kenyans
Have a mental health awareness campaign that promotes health-
seeking behavior and reduce stigma, discrimination and human
rights violations
ii. Facilitate reform in Mental Health Policy and Legislation
Facilitate a process of negotiation G2G (Government-to-
Government) of inclusion of psychotropic drugs to the National
Essential Drug List
Remove taxation (VAT, import, custom duty) on
psychotropic/antidepressant medication
There is no mental health Policy to-date. It is key to have mental
health services decentralized, accessible and available to the
communities both rural and urban
Institute a policy change to collect statistics specific to suicide
cases. Currently they are lumped together with homicides making
it very difficult to establish the rate of the incidences and
prevalence to provide corrective actions

P.O. Box 10071 00100
Nairobi Kenya
Tel. No.: +254 722 884565

CEOs
Office

Page 4 of 6

Promote user representation in the mental health
tribunals/boards to provide accountability and representativeness
which will be part of reforming human rights abuses and
objectivity of the mental health practitioners
Integration of mental health into the primary health care system.
Currently, mental health and physical health are managed
separately
Further refresher training sessions/workers for non-psychiatric
doctors to manage the incidence of mental health issues that
usually occur as physiological illness. It will increase better
diagnostic capability of health officers and create an effective
referral systems and decongest health centers.
Engage with mental health professionals to distribute burden of
care by task sharing and training the non-specialized medical
aspects to non-medical staff.
Promote task sharing whereby, the mental health professionals
will supervise the training of the non-medical staff who can
handle the simpler cases at point of contact and escalate the
more serious issues. Examples of Non-Medical Staff are Peer
workers (functional mental health users/survivors), Community
Health Workers, Social Workers, Religious leaders, faith healers,
traditional medicine men, village chiefs, police, prison warders
etc. Prof. Vikram Mental Health Care Manual Publication Where
there is No Psychiatrist. Can provide pointers on how to do this
effectively

b. Psychosocial Disability Approach. Facilitate the comprehensive implementation
of the the CRPD (Convention on Rights for Persons with Disability) an
international human rights treaty that is ratified by UK and Kenya among other
countries globally. The CRPD and other international treaties are part of Kenyas
Laws as per the Constitution of Kenya 2010 (CoK2010) Article 2 (4) and (5) the
(reception clauses)
i. The CRPD paradigm shift should guide DFID to avoid creating specialized
programs for persons with psychosocial disabilities and require that ALL
development programs include various persons with psychosocial
disabilities (including the other disabilities)

P.O. Box 10071 00100
Nairobi Kenya
Tel. No.: +254 722 884565

CEOs
Office

Page 5 of 6

ii. Encourage and promote positive obligation by
iii. the State of Kenya to include through the relevant DPOs (Disabled
Persons Organizations) to consult and invite participation by inclusion on
all other policy matters that will affect persons with disabilities (in our
case psychosocial disability). This includes the national legal framework,
developmental planning, budgeting and related policies

iv. DFID should also be guided by Article 32 of the CRPD on International
Cooperation for development of its disability programs

v. As per point (iii) above DFID should also borrow from Article 31 of the
CRPD on Statistics and Data collection to effectively promote the
measurement/performance indicators for its programs which will
mainstream disability in other areas of focusCapacity building, technical
assistance and training of DPOs in Disability Rights to improve the overall
well-being and inherent dignity of persons with psychosocial disabilities

vi. Embedding the essence of Article 12 of the CRPD in all the
programs/projects by providing the relevant support and reasonable
accommodation to ensure that all DFID programs are accessible to
persons with psychosocial disability. Reasonable accommodation
means necessary and appropriate modification and adjustment not
imposing a disproportionate or undue burden where needed in a
particular case, to ensure that persons with disabilities enjoy or exercise
on an equal basis with others all human rights and fundamental
freedoms, This coiuld be an adjustment made in a system to
accommodate or make fair the same system for an individual based on
established need..

vii. Facilitate the Kenya National Human Rights Commission (KNCHR) and
other stakeholders in Civil Society and Government to institute a Legal
Capacity Framework.

viii. Integrate the CRPD in all intersecting areas of operation of DFID for
persons with psychosocial disabilities.

P.O. Box 10071 00100
Nairobi Kenya
Tel. No.: +254 722 884565

CEOs
Office

Page 6 of 6

ix. Those are some of the recommendations that USPKenya would like to
put forward for now on Mental Health and Disability programs that DFID
should consider in its future projects and operations in Kenya; which are
applicable to most African countries but should be piloted. The UK has
strong links to Kenya not just Politically but Economically as well. If DFID
could use its influence as Government and to their Private Sector
operating in Kenya. They could help advance some or most of the ideas
that they consider critical to the development agenda for persons with
mental health conditions and psychosocial disabilities.

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Kangemi P.C.E.

A Church compound (Off Waiyaki Way)

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