Counselling is key in universal health coverage agenda

Counselling offers a lifeline by providing safe spaces, therapeutic interventions, and coping strategies for individuals struggling with mental illness. [Courtesy]

Globally, mental health is one of the most pressing but neglected health challenges of our time.

In Kenya, thousands of people urgently in need of counselling and psychological support remain without access to these essential, life-saving services.

While the government’s Universal Health Coverage (UHC) policy rightly acknowledges the role of counselling psychology in addressing mental health, the reality on the ground tells a different story. Services are scarce, stigma persists, and policy implementation remains weak.

Although the UHC framework envisions integrating mental health into primary healthcare, offering early detection, person-centered care, creating awareness, and easing the financial burden on families, individuals and organisations, the services still remain underrepresented, leaving behind vulnerable individuals who often suffer in silence.

To attain the UHC, mental health, and specifically counselling services, must be at the core of healthcare planning at both levels of governments.

It is important to note that the consequences of neglecting mental health are grave and far-reaching such as high incidences of suicide, a preventable cause of death.

Locally, we have and continue witnessing rising cases of suicide, cutting across age, gender, and socio-economic backgrounds.

Behind these numbers are individuals who could have been saved through timely and accessible psychological counselling.

The World Health Organisation (WHO) estimates that one in four people will experience a mental health condition in their lifetime. In Kenya, depression, anxiety, and substance abuse remain widespread, particularly among young people. Left unaddressed, these conditions disrupt families, erode productivity, and impose heavy financial and social burdens on communities.

Counselling offers a lifeline by providing safe spaces, therapeutic interventions, and coping strategies for individuals struggling with emotional or psychological distress. Yet these services are out of reach for many, especially in rural areas where healthcare systems are already over-stretched or not available.

However, several barriers continue to hinder the effective delivery of counselling services such as societal stigma, which continues to silence those in need and making it difficult for them to admit to seeing a counsellor or psychologist because it is often perceived as weakness or even madness.

While Kenya has made strides in recognising mental health as a priority through the Mental Health (Amendment) Act of 2022, implementation has remained largely slow due to policy gaps and inconsistencies which has left counselling services and access poorly resourced, and integration into UHC more aspirational than practical.

These has resulted into few trained counsellors and psychologists, and facilities offering therapy often concentrated in urban areas.

Marginalised groups, including those in rural and low-income communities, face the greatest barriers.

Addressing these barriers requires a multi-stakeholder approach through which the government, private sector, employers, NGOs, and other non-state actors must collaborate to create a robust system that makes counselling accessible, affordable, and equitable across all counties.

- The writer is the Human Resource and Partnerships Manager at the Pan African Climate Justice Alliance