Mathari National Teaching and Referral Hospital (MNTRH)
The World Health Organization has urged countries, including Kenya, to move away from keeping people with mental health conditions in hospitals for long periods and instead provide treatment and support within their communities.
The call for community care comes as concerns persist over the rights of people admitted to Mathari National Teaching and Referral Hospital in Nairobi, including patients who have remained there for many years and people admitted without their consent.
In February 2025, former Mathari chief executive Julius Ogato told Parliament that some patients committed to the hospital through court orders remained confined for more than 20 years, even after recovering.
Their release was complicated by legal requirements for further court directions and support.
Kenya has also faced concerns over laws that allow people to be admitted to mental hospitals against their will.
A 2016 report by the Kenya National Commission on Human Rights warned that the law made involuntary admission possible through applications by relatives and, in some circumstances, other people.
Mental health diagnosis and treatment remains a major problem in many developing countries where mental health issues are often unrecognised, stigmatised, considered curses or the results of witchcraft.
In a statement issued ahead of World Mental Health Day on October 10, WHO released a new guide to help countries change how they care for people with mental health conditions.
The guide recommends reducing long hospital stays and helping people return to their communities, where they can receive treatment while living with their families and taking part in everyday life.
“People should not have to give up their freedom, dignity or place in their community to receive ongoing mental health support,” said Dr Tedros Adhanom Ghebreyesus, WHO director general.
“Countries must move away from relying on long-term institutional care and accelerate the shift of investments from institutions to rights-based mental health care and support in communities.”
WHO called this change deinstitutionalisation. It involves helping people who have spent six months or longer in psychiatric hospitals return to community life, with the care and support they need.
The agency said nearly half of the people living in large psychiatric hospitals and social care institutions are kept there against their will for months, years or even decades.
WHO said moving people out of hospitals must involve more than simply sending them home. They need access to housing, health services, social support, education and jobs. Their families may also need help to support them.
Without these services, people may struggle to live independently or may be forced to return to hospitals.
Kenya has previously faced questions about the treatment and rights of people with mental health conditions.
A study published in 2022, which assessed Mathari using international human rights standards, found problems including inadequate staff, poor buildings, neglect and abuse.
It also found that the hospital lacked plans to help patients return to their communities and live independently.
The study recommended major improvements to the hospital and the way mental health services are provided.
WHO said worldwide progress towards community care remains slow. Its Mental Health Atlas found that only nine per cent of countries that reported data had fully moved to community-based mental health care. More than half, or 53 per cent, were still at an early stage of making the change.
The report also found that more than one in four people admitted to psychiatric hospitals stayed for longer than six months.
WHO said people who have experienced mental health conditions must be involved in decisions about the services they receive.
Community care was the focus of this year's World Mental Health Day themed, “Lived experiences heard: real voices, real change”.
The agency said people who have received care in psychiatric hospitals often have little say in decisions about how mental health services are designed and improved, even though their experiences can help show what works.
“Shifting towards community-based mental health care must be done with people who know what it means to go through institutional care, not for them,” said Grace Gatera, an independent lived experience consultant and advocate.
“Their expertise, alongside that of others, is essential to building services that support choice, recovery and participation in community life.”
The new guide was developed with experts from different countries, including people who have experienced mental health conditions. WHO says countries can adapt its recommendations to fit their needs.
The agency called on governments and health services to speed up the shift to community care and build services with people who have experienced mental health conditions.
