Funds, not sympathy, will end Kenya's mental health crisis

Two years ago, I met a young nurse in western Kenya who had quietly been battling depression for months. She showed up to work every day. She treated patients. She smiled. But she was exhausted, overwhelmed and afraid to speak up. She worried that seeking help would make her look weak or unfit for duty.

She did not need another awareness campaign. She needed access to affordable care that was built into the system around her. Her story is not unique. It is the lived reality of millions of Kenyans.

According to the Ministry of Health and the World Health Organisation, one in every four Kenyans will experience a mental health condition at some point in their lives. Yet more than 75 per cent of those who need care never receive it.

Kenya has fewer than 200 psychiatrists serving a population of over 50 million people. Public spending on mental health remains a very small share of the total health budget.

We do not have a mental health awareness problem anymore. We have a financing problem. Mental health is often framed as a social issue. It is also a serious economic issue.

Globally, the World Health Organisation estimates that depression and anxiety cost the global economy more than $1 trillion each year in lost productivity. In Kenya, the cost is visible in rising absenteeism, burnout, substance abuse and preventable deaths. Employers pay through reduced productivity and higher insurance claims. Families pay through lost income and instability. The government pays through strained health and social systems.

Untreated mental illness quietly erodes our economic potential. Yet mental health remains underfunded relative to its burden. In many low and middle-income countries, less than 2 per cent of health budgets go to mental health services, despite the high disease burden associated with mental disorders.

If we are serious about solving this crisis, we must move beyond sympathy and goodwill. We must bring finance to the centre of the solution.

In Kenya, we understand the power of financial incentives. When the government provides tax incentives for manufacturing, factories expand. When renewable energy receives tax support, solar adoption increases.

When affordable housing is incentivised, developers respond. Markets respond to incentives. So why do we expect companies to prioritise mental health without creating the right financial environment?

There is a need for a Mental Health Tax Incentive Framework that would allow companies to receive tax deductions or credits for verified spending on structured employee mental health programmes.

This would encourage employers to provide preventive screening, counselling and support services. It would reward companies that invest in the well-being of their workforce. It would formalise mental health as a legitimate business expense tied to productivity and resilience.

Mental health support should not be seen as corporate charity. It is workforce protection. Kenya’s pension industry manages over Sh1.8 trillion in assets, according to the Retirement Benefits Authority. Much of this capital is invested in government securities, real estate and listed equities. These are important investments.

But as a country, we must ask ourselves a difficult question. Are we investing enough in the mental resilience of the very workforce that funds these pension schemes?

It is time to think of mental health not only as a social good but as an investable asset class. Through instruments such as outcome-based financing and social impact bonds, private capital can fund preventive mental health programmes. Investors are repaid based on measurable results. Governments pay for outcomes achieved rather than services promised. Citizens receive care without immediate strain on public budgets.

Globally, similar models have funded public services in the United Kingdom and the United States, including behavioural health and supportive housing. Results-based financing has also been used in maternal health and infectious disease programmes in several developing countries.

If we can structure performance-based financing for roads, water systems and energy projects, we can structure it for mental health.

I call upon the National Treasury, the Kenya Revenue Authority, the Ministry of Health and county governments to explore structured mental health tax incentives and outcome-linked financing frameworks.

If we want a productive, resilient and stable Kenya, we must finance the minds that drive it.

Mr Mwangi is the Managing Partner of Thalia Psychotherapy