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Objective: To determine the knowledge, attitudes and beliefs about mental illness among staff in general hospitals. Method: A descriptive cross-sectional study conducted on staff in ten medical facilities in Kenya on their socio-demographic characteristics, professional qualifications and knowledge, attitudes and practice (KAP) toward mental illness. Results: A total of 684 general hospital staff: nurses (47.8%); doctors (18.1%); registered clinical officers (5.1%); students (9.5%) and support staff (19.5%) were recruited. About three quarters were under 40 years of age; most thought mental illness could be managed in general hospital facilities; the older the doctors were (age 40 years and older) the more they were aware of and positive towards mental illness. Most of the workers did not suspect any psychiatric symptoms among the patients they treated resulting in low referral rates for psychiatric services. Conclusion: There are gaps in knowledge on mental illness which could be constructively filled with Continued Medical Education (CME). Key words: Hospital, General; Health Knowledge, Attitudes, Practice; Mental disorders; Kenya

Objective : As there are no data on burnout in staff in Kenyan psychiatric hospitals, this study sought to document the level of burnout among the staff at the Mathari Psychiatric Hospital. Method : This was a cross sectional descriptive study of staff working at Mathari Psychiatric Hospital. The hospital staff completed self-administered questionnaires on socio-demographic characteristics and work environment and the Maslach Burnout Inventory - Human Services and General Survey. Analysis of the data was undertaken using the Statistical Package for the Social Sciences (SPSS) version 11.5. Results : Ninety-five percent of the respondents reported low to high emotional exhaustion while 87.8% reported depersonalization. Low accomplishment was reported by only 38.6% while 61.4% reported average to high personal accomplishment. Several work- and non-work-related factors including young age, number of own children, number of years worked, heavy workload and low morale were positively associated with various syndromes of burnout. Relationships at work, with family and society were generally rated as average. The staff made recommendations on how to improve the social support system and work performance. Conclusion : High levels of burnout were reported. These should be addressed at individual, collective and institutional levels.

Objective: Africa faces a skills shortage, in spite of training suitably qualified professionals. This is particularly evident in the discipline of Psychiatry. An analysis of the distribution and availability of psychiatrists in Kenya was thus conducted and findings compared with specific other African countries (Uganda and Zimbabwe). Method: Questionnaire, emailed to Heads of Academic Departments within the specified countries. Results: In 2004, there were a total of 53 psychiatrists practicing in Kenya, for a population of 31.5 million. The country has about 4,000 medical practitioners, with psychiatrists constituting 0.013% of the total number of medical practitioners. This is equivalent to a psychiatrist: population ratio of 1:594,339; doctor: population ratio of 1:7,875; a psychiatrist: overall doctors' ratio of 1:75.5, that is only 1.325% of Kenyan doctors are psychiatrists. When the psychiatrist: population ratios are considered on the basis of the provinces, then the ratios vary from 1:63,007 in the capital city of Nairobi to 1:4,393,19 in other provinces, with one without a psychiatrist for a population of 962,143. The ratios decline further when psychiatrists available for clinical work in public facilities are considered. Up to 34% (n=18) of all Kenyan psychiatrists were in private practice. The remaining 66% (n=35) were in the public sector, of whom more than 20 were in full time administrative or academic positions and therefore not available for full time clinical work in the public sector. Locally trained psychiatrists, compared with foreign trained psychiatrists, fared better on: non-migration to other countries, working in rural rather the urban areas, working in public rather than private sector and in overall academic achievements. Conclusion: In the fore-seeable future in Kenya it will not be possible to achieve a psychiatrist: population ratio equivalent to that in Western countries, both in terms of overall ratio for the country, and more importantly, for the average distribution within the country. For the needs of Kenya, and other developing countries, local training of psychiatrists is superior to foreign training in several parameters. If Kenya and other similar developing countries in Africa are to achieve realistic mental health service delivery in the foreseeable future, alternative non-specialist training in mental health is required. Conflict of Interest: None. This study was conceptualized by DMN. It formed the basis of the Key Note speech at the WHO Regional Conference of Psychiatrists, Arusha, Tanzania 2004. It was funded by the Africa Mental Health Foundation (AMHF). Keywords : Kenya, Questionnaire, Mental health > South African Psychiatry Review Vol. 10 (1) 2007: pp 33-36