By Steve Otieno
Initially dismissed as stubborn and then labelled as mad, Abdi Mohamed’s journey into depression and drug abuse began with fractures in his family. Where he was once embraced with love and admiration, he found himself abandoned, seeking solace in the ancient walls of Fort Jesus in Mombasa. He would find himself drinking mnazi, the locally brewed liquor, and walking around with a few paper bags for carrying his only possessions —symbols of a life spiralling into addiction and despair.
“Everyone saw in me, a drug addict and an alcoholic and no one wanted to associate with me. This rejection, by people, including my family, stung me deeply,” he said, speaking at the Mombasa Women Empowerment Network (MWEN), where he is undergoing rehabilitation. He remembered how his nights were haunted by doubts and fears, and how his desperate plea for help that went unheard.
Mohamed’s troubles traced back to his father’s abandonment, which left a void that shattered his world.
“I was close to my dad, but one day he disappeared” he recalled.
His quest to reconnect, seven years later, ended in disappointment and fuelled his descent into depression and substance abuse.
“I eventually found him. He had remarried, and when I thought I could rekindle our relationship, it did not work. I fell into depression and my troubles began,” he said.
At the height of his turmoil, Mohamed dropped out of high school, fleeing to the streets.
His family’s attempts to intervene only pushed him further away until he found refuge at Fort Jesus. It was there, sleeping at its foot, that his family finally reached out to his maternal uncles, who brought him to MWEN for rehabilitation.
“We took him for therapy sessions and we diagnosed him with depression. He was also struggling with drugs and alcohol abuse and we knew the withdrawal effects would be severe for his advanced stage,” recounted Amina Abdalla, the founder of the MWEN.
“The day the young man was brought to the facility, he was distraught, bewildered and angry at everyone, including himself,” she said.
Ms Abdalla witnessed Mohamed’s arrival—a young man distraught and angry, grappling with addiction and mental illness worsened by societal stigma. Thankfully, through rehabilitation, Mohamed has found a path to recovery, supported by skills training in electronics, paving the way for a future beyond addiction.
“Stigma and traditional beliefs remain barriers to mental health in our community”, Abdalla lamented.
Mental illness and addictive behaviour
Mohamed’s story resonates with Eunice Omollo, a journalist battling bipolar disorder, 475 kilometres away in Nairobi. Eunice went through a perpetual cycle of highs and lows, often numbing her pain with alcohol and sleeping pills.
Her most recent relapse into alcohol abuse happened when she lost her job, with the resulting loss of stability and income from the job that she had after months of searching becoming too heavy for her to bear.
Eunice’s struggle with mental health crises highlights the gaps in Kenya’s healthcare system, where stigma and inadequate resources compound the burden of illness. To cope, she resorted to alcohol to ‘calm’ the demons that tormented her. When she could not access alcohol, she would consume sleeping pills to escape reality and ‘sleep away’ her problems.

“I had several depression episodes”, Eunice says, adding, “I am also a suicide survivor. It started when I was in high school where I had my first attempt. It is then that I was diagnosed with bipolar type 1.”
With bipolar disorder, a patient experiences hypomanic episode where one’s moods are so high, one is hyperactive and excited, then suddenly, one goes low. Drugs and alcohol are often used as a coping mechanism, sometimes with detrimental consequences.
“The sad part about being bipolar is that your brain does not know when to make you happy or make you sad. It just erupts. So, when my lowest lows come, it will be as low as the highest highs and I become more depressed,” Ms Omollo said.
There are countless others like Mohammed and Eunice, each with their own stories of shattered dreams and fractured relationships, abandoned not only by their families but by a society that often looks away. The stigma of addiction hangs heavy contributing to a cycle of shame and isolation.
According to the World Health Organisation (WHO), globally, depression, anxiety and behavioural disorders are among the leading causes of illness and disability among adolescents. Also, suicide is the fourth leading cause of death among 15-29-year-olds. Additionally, one in seven 10-19-year-olds globally experiences a mental disorder, accounting for 13% of the global burden of disease in this age group.
In Kenya, the situation is especially dire, with the WHO indicating that 1 out of 4 persons who seek healthcare has a mental health condition.
A shortage of facilities
Mohamed’s home county, Kilifi, has only three primary mental health clinics located at Malindi Sub-County Hospital, Mariakani Sub-County Hospital, and Kilifi County Referral Hospital, meant to serve the county’s 1.2 million people.
Nairobi, where Eunice lives, is slightly better, although accessibility of mental health facilities services remains a significant challenge. While there are some public and private facilities offering mental health services, they are often overstretched, in the case of public facilities such as the Mathari Mental Hospital, or prohibitively expensive in the case of private facilities, leaving many underserved.
Additionally, the stigma surrounding mental health hinders help-seeking behavior, exacerbating the issue. Consequently, access to quality mental healthcare remains limited for a large portion of Nairobi’s population, and this lack of access is particularly severe in marginalized communities and the poor.
Kilifi is ranked as the eighth poorest in Kenya, and suffers an acute shortage of mental health services because none of the listed facilities have in-patient services.
A survey by the Kenya National Bureau of Statistics showed that in in 2018, there were 104,615 cases of mental illnesses reported in hospitals across the country, with Mombasa leading among the coastal counties with 4,620 cases, followed by Kilifi’s 2,353, Taita Taveta with 2,242, Kwale 1,011, Lamu 734, and Tana River 519.
An April 2017 survey by the International Journal of Mental Health Systems (IJMHS) indicated that Kilifi county has two public psychiatric outpatient units that are part of general hospitals.
There is also an acute shortage of qualified personnel to handle psychiatric cases in Kilifi.
The IJMHS study found that there are no resident psychiatrists or psychologists, and there were only two psychiatric nurses, a woeful number given the county’s population. Alarmingly, there is no standalone mental hospital in Kilifi, and no inpatient or community-based facilities for people with mental health problems in the county.
The number of facilities for mental health cases has however received a boost following the establishment of three mental health centres in rural areas at Ganze, Kaloleni, and Gongoni being the latest opened in April 2023 to serve the community.
“Depression is common and there are increasing rates of substance and alcohol use disorders. While the country does not currently have a specific budget for mental health, the good news is that Kenya established a Mental Health Taskforce last year,” a WHO report stated in 2021.
The WHO report also pointed out that failure to address adolescent mental health conditions means that they often extend to adulthood, impairing both physical and mental health and limiting opportunities for the affected individuals to lead fulfilling lives as adults.
‘Pepo mbaya’
For Ms Abdalla, there are a lot of myths associated with mental health illnesses which negatively affect patients who end up being mistreated for something that is treatable.

“In several villages across Mombasa, Kilifi, Kwale and Lamu, they believe that such a person has been affected by “pepo mbaya” (evil spirits), which means someone cast a spell on them or the family is cursed. We must raise awareness for this to change,” she said, adding that funding is her utmost limitation.
Despite the effort and progress made, she lacks the necessary financial resources to expand her reach. Though she is currently based in Mombasa, she receives patients from the surrounding counties and at times, some come in from as far as Tanzania and Uganda.
The county and national government are yet to offer any form of substantial assistance even though she and her team move around the county rescuing street children and persons with mental health illnesses who are often dismissed as mad persons.
Dr. Mercy Karanja of Kenya’s Ministry of Health underscored the need for integrated mental health services, citing a shortage of facilities and specialists. With only 14 hospitals equipped for psychiatric care across 47 counties, access remains a critical issue.
As Mohamed and Eunice strive for recovery, their stories illuminate the urgent need for mental health awareness and support.
“Never again will I look at drugs and alcohol, in fact, if I see a bottle of liquor, I will change my destination and go the opposite direction. Mental health should be treated like any other disease. I am getting better and soon, I will be as fit as a truck driver,” Mohamed concluded.
This story was made possible with the support of the UZIMA-DS project, funded by the National Institutes of Health (NIH)
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