A middle-aged man in a counseling session with a psychiatrist. [Getty Images]

Imagine being sick and instead of being treated to get better, you are forced to go through a judicial process.

Suicide is one of the frowned upon symptoms of mental illness, but the law in Kenya makes it a criminal offence. In a country where people with mental illness have almost no options, should the victims be blamed? And what are their options?

Suicide remains one of the most controversial topics in Kenyan and African societies. Also known as self-homicide, suicide is described as death caused by injuring yourself with the sole intention of dying.

A suicide attempt is when someone harms themselves with the intention of ending their life, only they do not die as a result of their actions. In Kenya, those who attempt death by suicide face criminal charges.

In many African cultures, suicide is considered a moral issue and an abomination if not a curse. Kenya Penal Code Section 226 states that anyone attempting to kill themselves is guilty of a misdemeanor offense and is liable to up to two years’ imprisonment, a fine, or both. The minimum age for prosecution is 8 years old.

Julian Onyango, a 37-year-old suicide survivor, says the law can push people with mental illness to their limits.

“If I have a mental health issue that is driving me to complete my suicidal ideation and instead of helping me, you are taking me to jail. I will automatically complete suicide there. I will not ask for help because it is criminal, especially us men,” she says.

Julian represents that many Kenyans are battling mental illness.

“Unfortunately, many see it as attention seeking, and we need help,” she says.

According to the World Health Organization, approximately 700,000 people die by suicide each year, making it the second leading cause of death among people aged 15 to 29. It is also among the top ten causes of death among all age groups.

In Kenya, at least four Kenyans die by suicide every day, with an average of 20 times as many attempting suicide. These are conservative figures given that suicide is both a taboo subject and a crime, thus rarely discussed in public.

Traumatic experiences, coupled with stigma, lead some to attempt or even complete suicide. For James Karanja, 31, born intersex, these two factors were responsible for his three suicide attempts.

James lived as a woman named Mary Waithera for the first 18 years of her life.

“When I was born, it was a shock. I was born in the house as I did not lie under the well-known feminine/masculine gender. They took me to a traditionalist and were given two ultimatums, kill me or cut away what they deemed of no value: they felt they had to correct me. Luckily, my grandmother decided to raise me,” says Karanja

Karanja has been constantly stigmatized and ostracized. “My grandmother limited my commitments with the other children, she was afraid that everything she had hidden for so long would be brought to light. I grew up a loner,” she adds.

Karanja would later join Molo Girls Secondary School. Having grown up as a girl, he was gripped by a gender identity crisis when he met other girls.

“The first time I noticed I was different was when I woke up to take a shower and realized I didn’t have breasts like other girls. That’s when I started withdrawing from other students,” Karanja says.

The students were afraid to confront him about his differences as he was chosen to be an assistant head boy who later became the head boy. But the challenges haven’t been completely canceled.

“Girls were attracted to me and the school thought I was trying to promote lesbianism, so they kicked me out of school. Even though they called me back and I was able to complete high school, I thought life would get easier considering it was the teachers who were teasing me for looking different,” adds Karanja.

Karanja moved to another city Nyandarua to start a new life but his hopes were dashed yet again as most of the locals knew him from her early days as a woman.

“They stripped me to find out why I presented myself as a man, when in fact they knew me as a woman. After undressing me, they ran, shocked by what they saw. I never understood the logic behind it,” says Karanja.

“That’s when I started having suicidal thoughts. I couldn’t find work because I was an outcast and some believed I was a bad omen. I could never walk in peace without someone pointing fingers at me,” adds Karanja.

Karanja, overwhelmed by society’s stigma and self-loathing, attempted suicide three times. It was in his last attempt that he began to take his mental health seriously.

“I had just attempted suicide. I left home. I have seen two people laugh during a conversation. As a revelation, it occurred to me that even if I completed the suicide, the two people would still laugh. I had to accept myself and start living a positive life,” Karanja says.

“I didn’t want to kill myself because I didn’t want to live, it was just because I wanted to end the pain,” adds Karanja

“It is crucial to indicate that no one is supporting the ideation, attempts or even completion of suicide. It’s just that death by suicide happens, so it needs to be addressed,” says Petronella Mukaindo, deputy director of the Kenya National Human Rights Commission and a researcher specializing in political and legal issues.

By criminalizing suicide, some argue that the law is discouraging people suffering from mental health problems from seeking treatment, thus promoting suicide completion to avoid serving jail time.

“I can’t imagine calling the police on my patients as they seek treatment. I wouldn’t help them,” says Dr. Chitayi Murabula, a psychiatrist and president of the Kenya Psychiatrist Association (KPA).

Sixty years since Kenya gained its independence, there are those who think that the criminalization of suicide is a colonial relic.

“You must realize that this is a colonial law of the British colony. Most British colonies still enforce this colonial law, even though the British decriminalized suicide in 1961, long before Kenya’s independence. Amazingly Kenya is still holding on to it,” says Ms Mukaindo.

According to Dr Chitayi, a psychiatrist and head of the mental health department of Kenyatta National Hospital, up to 25% of people who visit the outpatient section in hospitals suffer from mental disorders. And up to 40 percent of those who arrive in hospitalization sections also fall into the same range. Yet some 22 counties in Kenya lack the facilities that can handle these conditions.

“It’s expensive to be mentally ill in most counties. Patients are forced to travel to receive treatment and almost all are referred to Mathare, leaving Mathare overburdened,” says Dr. Chitayi.

“Troubled health systems predispose many of our people to suffer from chronic mental health conditions,” adds Dr. Chitayi

Mental illness is no longer a silent pandemic

This is despite section 3 of the Mental Health Act providing a framework for promoting the mental health and well-being of all people, including reducing the incidence of mental illness. It also promotes the provision of mental health services in primary health care facilities and pushes for the recovery, improvement, rehabilitation and integration of people with mental illness into the community.

All of these policies have yet to be met.

According to the goal of the Suicide Prevention Strategy 2021-2026, Kenya is striving to achieve a 10% reduction in suicide mortality by 2026. Currently, Kenya is facing an increasing burden of mental illness.

Despite the dire situation, the Kenyan government’s total spending on mental health is approximately 0.01% of the total health budget. This underfunding has made mental health care unaffordable for many.

They say children are like a sponge. They observe, absorb and imitate. Guyana Onyango Julian, 37, is a mental health advocate. Julian has struggled with alcoholism for more than 17 years. He says his first interaction with alcohol was when he was only 8 years old.

“My father never had a good relationship with alcohol. We all picked it up in my family. Right now I’m the only one sober. We lost both my father and brother to alcoholic complications, the toxic cycle made me attempt suicide three times,” says Julian.

“It started around 2010, I was a young man with a good job, I had suicidal thoughts and attempted it,” Julian recalls.

Julian would later be diagnosed with bipolar disorder, a mental condition characterized by extreme mood swings. Classified as both a mood disorder and a mental health condition.

Her breakthrough was in the year 2019 when she attempted suicide and the police were called.

“I was drunk when the police were called to pick me up. Luckily someone offered help in a different way, he said we need to look deeper. It was then that I was taken to Mathare hospital by the same police car that was supposed to take me to prison,” says Julian.

“I’m sure if I hadn’t received medical treatment and been incarcerated, I would have completed suicide there,” Julian says in a shaking voice.

In June 2019, Kenya’s fourth President Uhuru Kenyatta said in his Madaraka Day speech, “Depression has become a common phenomenon today, affecting people of all walks of life and ages.”

As a result of these observations, a mental health task force was formed. One of his key recommendations was the declaration of mental illness as a national emergency of epidemic proportions.

On World Suicide Prevention Day 2020, the Kenya National Commission on Human Rights called on the legislator to decriminalize attempted suicide through the repeal of Section 226 of the Penal Code.

In 2021, the bill to amend the penal code was presented to parliament, in an attempt to repeal several articles. Including section 226 attempted suicide, and I quote,

“The bill decriminalizes attempted suicide to ensure victims get needed care in line with the Mental Health Act. Attempted suicide is a mental health issue that should not be subject to criminal prosecution.”

In 2022 the Kenya National Commission on Human Rights (KCHR) filed a constitutional petition to strike down the section as unconstitutional. Charity Muturi, a person living with a mental illness, and the Kenya Psychiatric Association were co-signatories. The appeal claims that the law as it stands violates the rights of people living with mental health conditions. The case was mentioned on May 18, 2023, before Judge Mugure Thande.

This paints a full picture of the grim state of mental health in Kenya. A sad state that goes against the Kenyan constitution, among other laws and internationally enshrined human rights.

Article 43(1)(a) of the Constitution clearly states that every Kenyan is entitled to “the highest possible standard of health, which includes the right to health care services, including reproductive health care”.

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