It will take us more than 6 weeks to get a basic psychiatric evaluation; your guide to getting a forensic test at Mathari Hospital’s Maximum Unit

2:06:00 PM

29th June is when we can get our evaluation

Good afternoon beautiful souls,

I am so glad to be back in the office after my burn out/break down/fall out/time out/zone off.

This week is Schizophrenia Awareness Week here at My Mind, My Funk so every day I will be talking about schizophrenia here on the blog and on our twitter and facebook pages, we will also be doing FREE phone counselling all week from 8-1p, simply text your mental health issue to 22214 and our counselors will get in touch (PS: the 22214 service no longer available) plus tomorrow (Tuesday) and on Thursday, we will have 2 awareness gigs at health facilities around Ngong area…we got to get this information and support to the masses, so share the blog posts, the tweets and FB posts.

Whenever a Kenyan hears mental health, they think of two things; Mathari Hospital and Schizophrenia (better known as Uenda Wazimu)...allow me to burst your bubbles though; there are many other places and things one can do other than go to Mathari and there are many other mental health conditions besides Schizophrenia. I will start our awareness week by talking about my visit to the Maximum unit at Mathari Hospital, yes I know, I talk about this place way too much.(Read about Mathari Hospital history)

Mathari as I have previously mentioned is the National Teaching and Referral Hospital for matters mental health, and should therefore be used as a referral but since we are not demanding our county governments to provide mental health services, we end up trying to squeeze everyone there, hence all the nasty stories of understaffing, under funding and overcrowding. Among its many services including maternity, the hospital also has a unit where people who have committed crimes and have a mental health condition are housed called Maximum Security Unit or simply Maximum. Most of the people here have schizophrenia and commit crimes when in the hallucination/delusion side of the illness.

Maximum is among the original structures set up in the hospital way back when and my very first time getting inside the unit was when we were helping Conjestina who was put there to calm her (she was very violent) and not to excite the other patients in the wards and trigger her further, she was later moved to the VIP section of amenity ward. Normally when one commits a crime, mostly murders or violent acts, the judge orders for a forensic test to determine one’s state of mind before giving a sentence. During this time, one usually in custody and once this test is done and shows you have a mental health condition; you serve your time while getting treatment and this is how one ends up at the Maximum Unit.

Two weeks ago, I was at Maximum again accompanying a client who has a looooooong overdue court case. We had initially gone to Mathari the previous week to get his records but the judge insisted on a forensic test and so we went to get one. Early last year, I attended a session on forensic reporting hosted by the Death Penalty... Little did we know that we have to wait, not for a few hours but for more than 6 whole weeks. This is how getting scheduled for a forensic test happens;

1. The doctors only see people on Mondays and Thursdays. (We have 79 psychiatrists, the number keeps shrinking when you say public-private then at Mathari, around the country etc etc they have to do ward rounds, among many other things so they are only available on these two days – We just have to deal)
2. They can only see 10 people a day (the scheduling book only has 9 names per day with a 10th slot left for urgent cases, when the very patient and hospital booking guy was taking us through this process, I was in awe and as he flipped through I would see kamiti, kamiti, kamiti meaning people already in kamiti who need to come for a test)
3. We got a spot for Monday 29th June (more than 6 weeks from when we booked…do you know what can happen in 6 weeks? Me and aspiring boo can be a real couple and make plans for the future with room for my life partner, my hair can get to braidable length, world peace can be achieved even if in the furthest corner of our minds, the world can end and be forgotten about)
4. If for one reason or another, the doctor doesn’t show up on their day…CHAAAAOS!!!

So what do we do, wait…we just have to wait.

The mental health bill that is still in a kitchen or shelf somewhere has a session that talks about this category of persons living with mental health conditions but something HUUUUGE needs to be done before that bill sees the light of day.

Before the test, this person who has committed the crime is in remand without much needed treatment should he/she actually have a mental health condition, then incentives, incentives incentives should be given for more people to get into mental health, I know WHO came up with the mhGAP where clinicians and community health workers can have mental health skills but a whole lot needs to be done, I am also for special mental health courts with dedicated health personnel and mental health sensitive judges because the way my client is treated in that court room just aint just. This whole experience just made me feel that the crime itself isn’t your first crime, the fact that you have a mental health condition is actually a crime…why else should you go through all this? 

Keep it here for more on what actually happens during the forensic test and how the court case goes after we take back the results, 6 weeks from now.

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