Ethiopia's-Mental-Health-Crisis

Ethiopia’s Mental Health Crisis

A Growing Burden on Amanuel Hospital

For many years, Amanuel Hospital has been Ethiopia’s sole mental health services provider. With increased awareness about the illness and rising demand for care, many government and private hospitals have started integrating mental health care with other services. There has also been an increasing number of private practices in the capital and big regional cities. Despite these changes, the burden on Amanuel Hospital remains. The hospital accommodates 500-600 patients daily. With rising demand for holistic care, shortage of staff, and inadequate funding, one of the oldest health institutions faces multifaceted challenges, including the need for more resources, better infrastructure, and increased public awareness. EBR’s Dr. Brook Genene assesses the current situation of the hospital and the state of mental health care in the country.

As Ethiopia’s largest mental health service provider, Amanuel Specialized Hospital is experiencing a significant surge in demand. The number of patients visiting the hospital daily has been steadily increasing, with recent data showing a doubling in the past year. Last year, the hospital provided services to 114 thousand patients, a number that exceeded the planned 135 thousand.

There has been a continuous outcry from different stakeholders for changes in how the service is delivered. Since the hospital is not fully equipped to provide all the necessary health care services, expansions and policy alterations have occurred. One of these changes has been the construction of a new building offering internal medical care.

Dr. Kibrom Haile, a Psychiatrist and the Medical Director of Amanuel Hospital, emphasizes the hospital’s commitment to comprehensive care. He states, “Only treating mental health issues isn’t right because patients need comprehensive care.” This commitment is evident in the completion of a new building, ready to provide health services to those in need, reassuring patients and their families of the quality care they can expect at Amanuel Hospital.

One of the primary necessities for having other health services within the hospital has been the problem faced during referral. “The stigma is very worrying,” Dr Kibrom told EBR. Some hospitals are not willing to accept patients from Amanuel Hospital. He recalled a patient who was denied service at a hospital but was later accepted after no longer being associated with Amanuel Hospital.

Dr Kibrom also points to the need to use primary care services to address the demand effectively. He explained that many people from faraway areas come to Amanuel Hospital when they can get treatments in a nearby health centre.

“There are patients who come all the way from Asosa to be treated in Amanuel. Even when the insurance companies cover the cost of the treatment, the extra cost for transport and housing is too much,” Dr Kibrom said.

He added that health centres and General hospitals should be able to treat most cases and only refer them to specialized hospitals when they are too complicated or beyond their capacity.

Ethiopia’s health tier system consists of three healthcare systems. There are health posts, health centres, and primary hospitals at the primary healthcare level. A total of 40,000 people are said to be accommodated at this level. General hospitals are included in the secondary level. These are responsible for helping between 1 and 1.5 million people. Specialized hospitals are at the final stage, ready to provide services to up to 5 million people.

The Ministry of Health’s strategy has shifted from having a large service provider like Amanuel Hospital to making mental health services available at every stage.

Significant strides have been made towards achieving this goal. The recent expansion in the number and mix of mental health professional training, increase in public and private mental health services, and more integration of mental health services in health centres and hospitals have all been mentioned as steps in the right direction in the ministry’s mental health strategic plan, which runs from 2020 to 2025. These developments give hope for a brighter future in mental health care in Ethiopia.

But the challenges remain. One issue yet to be fully addressed is the low level of awareness by political leaders, the public, and health professionals about mental health problems. Despite numerous initiatives in both mainstream and social media to talk about mental health issues, the desired goal has yet to be achieved. The ministry has also identified Inadequate and inequitable resource allocation for mental health care, a struggle that the hospital continues to face.

People with mental health conditions face a wide range of human rights violations within the community, traditional treatment settings and in the health care context. They are often denied their fundamental human rights or discriminated against regarding employment, promotion, education, and housing. As a result, people with mental health conditions are left in poverty. The lack of access to appropriate care can lead to a marginalized existence, a protracted course of recovery, and lower quality of life in general.

Dr Kibrom states that significant work is underway to provide all the necessary patient care in one place. This marks a significant shift from the previous practice of sending patients to different facilities for their various issues, and it is a step towards a more integrated and efficient mental health care system.

Amanuel Hospital currently has 268 beds, but it has been said that more is needed to satisfy the public’s needs. According to Dr Kibrom, the low number of professionals has also been an issue. “We posted a vacancy looking for a Psychiatrist on a contract basis but didn’t succeed,” he told EBR.

He mentioned a stigma attached to working at Amanuel Hospital, and many people choose to avoid that. The hospital currently has only eight psychiatrists caring for 500 patients daily. “It is recommended that one Psychiatrist doesn’t see more than ten patients per day for the best care,” Dr Kibrom said, but he highlighted how difficult it is to implement that at the moment.

In addition to Psychiatrists, the hospital has Clinical Psychologists and Psychiatry Professionals with a nursing or public health background who have completed their master’s in mental health care. However, the overwhelming number of cases still burdening the hospital.

Most of the cases at Amanuel Hospital are related to Psychosis. This is when a person cannot think usually and has trouble knowing what is real. A person with рѕусhоsis might have hаllucinаtiоnѕ, delusions, and disorganized speech or thinking. Hallucination is when a person hears, sees, feels, smells, or tastes things that aren’t there. Delusion is when a person believes things that are not true. Disorganized thinking or speech is when a person cannot think or talk clearly.

Ρѕуchоѕiѕ is usually linked with mental illnesses like ѕchizοphreniа or bipolar disorder. Most of the patients at Amanuel Hospital are diagnosed with these illnesses.

“We usually treat the most severe cases but that doesn’t mean those are the majority of cases in the society”, said Dr. Kibrom.

With mental illness being one of the rising public health concerns, the need for a strategic approach has been identified as necessary. The latest strategy from the Ministry of Health states mental health should be valued and promoted. It also asserts people should be protected and prevented from risk factors, and persons with mental health conditions get quality, rights-based health and social care in a timely way. Promoting mental well-being, preventing mental disorders, providing care and enhancing recovery of persons with mental health conditions and psychosocial disability has been set as the goal. EBR


13th Year • November 2024 • No. 135

Author

Dr. Brook Genene

Deputy Editor-in-Chief of Ethiopian Business Review (EBR). He can be reached at brook.genene@ethiopianbusinessreview.net


Leave a Reply

Your email address will not be published. Required fields are marked *



Ethiopian Business Review | EBR is a first-class and high-quality monthly business magazine offering enlightenment to readers and a platform for partners.



2Q69+2MM, Jomo Kenyatta St, Addis Ababa

Tsehay Messay Building

Contact Us

+251 961 41 41 41

Author

Addis Maleda
x