by Victoria de Menil, David Ndetei, Milka Waruguru, Martin Knapp, David McDaid
In much of sub-Saharan Africa, community mental healthcare and specialist mental healthcare are not synonymous. Apart from traditional and faith healing, primary care providers are thought to be the sole purveyors of mental healthcare outside of hospital settings, while specialists operate through hospital-based outpatient clinics. While true of the public sector, this dichotomy is missing something. The hidden face of community mental healthcare in Africa is private specialist providers in outpatient settings.
Kenya serves as an interesting case study, since its private health sector is particularly well developed. We conducted a small-scale study, administering semi-structured interviews to 11 private mental health specialists (8 psychiatrists, 3 psychiatric nurses) from the capital and a more rural area to better understand what services they provide, what type of patients were accessing those services, and at what cost.