How Kenyan physicians treat mental disorders

Abstract

Objectives: To determine the psychological problems the non-psychiatric doctors commonly encounter, the treatment offered and/or referrals made and to determine any obstacles met in providing psychiatric treatment or making referrals. Design: Cross- sectional survey. Setting: Kenyatta National Hospital, Nairobi, Kenya. Subjects: Doctors working at Kenyatta National Hospital. Results: One hundred and thirty (94 males and 36 females) doctors subm .t .J usable questionnaires. Seventy eight per cent of the respondents were below 35 years and 57 had less than five years experience. The commonest psychiatric disorders seen by doctors were anxiety, depression, psychosomatic disorders and organic psychoses similar to findings in previous prevalence studies. Drugs therapy with anxiolytics antidepressants and antipsychotics were commonly utilised. Brief counselling was the verbal form of treatment most commonly used. Referral to mental health workers was less often done. Obstacles cited by the doctors were the patients' resistance to referral, lack of coordination and insufficient knowledge to treat the disorders. Conclusion: The doctors recognise that psychiatric disorders are common among their patients but they have major obstacles in managing them. These findings are discussed and remedial measures suggested.