How noxious work environments are aggravating mental health crisis

World Mental Health Day was marked on October 10, 2024, with many employees trapped in toxic work environments, feeling used, abused, and mistreated by their bosses and, sometimes, colleagues.

In June 2021, the body of Dr Lydia Wahura Kanyoro was found inside her car, moments after she had died by suicide, a move that prompted calls to address mental pressure among student medical practitioners.

Last month, the medical fraternity and Kenyans at large were thrown into shock, yet again after Dr Desree Moraa Obwogi, a 26-year-old medical intern at Gatundu Level 5 Hospital, tragically took her own life.

Moraa had reportedly experienced burnout due to long working shifts (36 hours non-stop) and unpaid salaries, forcing her to depend on friends for accommodation.

According to the Kenya Medical Practitioners and Dentists’ Union (KMPDU), more than seven cases of suicide among doctors have been reported in the past three years alone.
Dr Chibanzi Mwachonda, a Senior Psychiatry Registrar at the University of Nairobi and Mathari National Teaching and Referral Hospital, notes that apart from poor working conditions, many doctors experience moral injury, a type of psychological trauma that occurs when healthcare workers are unable to provide the care due to constraints beyond their control.

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“The thought that you could have done something to save a patient’s life but you couldn’t, can lead to feelings of guilt, shame, and helplessness, contributing to mental health issues,” he explains.

Poor implementation

Dr Ridge Omangi, a medical intern doctor at the Kenyatta National Hospital, states that intern doctors are often pushed to their limit in the name of gaining experience. He adds that this pressure affects how doctors provide care to their patients.

“A healthy doctor equals a healthy nation. When I am stressed or depressed as a doctor, I might even forget how to perform resuscitation on a patient, which could lead to loss of life,” he explains.

KMPDU Secretary-General Dr Davji Atellah says, “There are comprehensive policies in place to ensure that doctors work in a conducive environment and optimally, but proper implementation is lacking.”

According to the World Health Organization (WHO), poor working environment, including discrimination and inequality, excessive workloads, low job control, and job insecurity pose a risk to mental health.

Globally, an estimated 12 billion working days are lost every year to depression and anxiety, amounting to US$ 1 trillion per year in lost productivity. These statistics may have informed this year’s World Mental Health Day theme, “It is time to prioritise mental health at the workplace.”

Thirty-five-year-old Wilmina Okumu still carries the scars of a toxic work environment that led her into depression some three years ago. According to Okumu, a journalist, her boss was a narcissistic gas lighter who did not want to see her grow in her career. This, she says, led to a decline in productivity and how she related with the people around her.

“She would not let me go for work trips, and she did not commend my work no matter how well I performed. She would also discuss me, not in a positive way, with other bosses, and I would always report to work wondering if I was good enough for the role.”

At the same time, Okumu says that when she requested to move departments, her boss refused to approve the move based on “the desk being understaffed.”

Okumu, who was a mother of three then, would find it hard to relate well with her children and husband during that period. She now realises, in hindsight, that it was because she would project her stress from work onto her family.

“Nobody should ever work under a toxic boss; it affects everything you do,” she emphasizes, adding, “Human resource managers must listen to their employees and act accordingly whenever they raise issues of toxicity at workplace.”

According to research by “The Self Investigation,” mental health has become one of the most important challenges for media professionals all over the world.

Burnout, anxiety, Post Traumatic Stress Disorder, and vicarious trauma are on the rise. Despite this, mental health struggles in journalism remain stigmatised and are seldom openly discussed.

According to WHO, of the 60 percent of the world’s population that is in work, an estimated 15 per cent were reported to have a mental disorder in 2019.

Short term contracts

In Kenya, this implies an estimated 3.7 million of the 24.9 million workforce might be living with various kinds of mental health conditions.

Tabitha Mwangi, an ECD teacher in Nyeri County, is one of the affected. While her employer and immediate boss understand her condition, Tabitha says her colleagues often stigmatise her, an issue she hopes the Ministry of Education will address.

“I often do my work to the best of my ability, and my boss is happy with my work, but some of my colleagues and most parents often doubt whether I will be able to teach their children well,” she says.

According to the Kenya Women Teachers Association (KEWOTA), close to 60 teachers have died by suicide in the past three years alone.

Mental health issues among teachers have been attributed to workload pressure, alcohol and substance addiction, work transfers that lead to separation of teachers from their families, stigma, and lack of counseling and professional help, among others.

Teachers Service Commission CEO, Dr Nancy Macharia, says the commission has put measures in place to ensure that teachers who are affected by mental health issues are accorded the necessary support. 

“We recognise the extraordinary work that head-teachers and other staff in schools do, and we take their well-being very seriously. We have introduced a comprehensive health insurance cover with AoN Minet for all teachers,” Dr Macharia affirms.

Shamir Kaunda, an agronomist, also lives with a mental health condition. According to Kaunda, engaging in short-term jobs has reduced the chances of him being mistreated.

“With short-term contracts, the chances of being misused and mistreated are minimal as long as I fulfill the terms of reference on the agreement,” he says. Shamir, who is currently engaged with the State Department for Social Protection and Senior Citizen Affairs, adds that he has previously lost employment opportunities due to his condition, which led to hospital admission.

A report by the Ministry of Health shows that workplace mental wellness has been a priority issue in the last few years, particularly with the emergence of the Covid-19 pandemic, which led to significant disruptions in traditional work models.

The shift to remote work has adversely impacted lifestyle changes, including reduced physical activities, unhealthy diets, and sleep disturbances.

Additionally, there was a loss in interpersonal interactions with co-workers and customers. These changes significantly impacted the well-being and mental wellness of employees across the globe.

Evidence shows the direct influence of employee mental health status on job performance, morale, and capacity to work.

Prioritise self-care

Moreover, there is a direct economic impact of employee mental health problems on employers and businesses through increased absenteeism, a negative impact on productivity and profits, as well as an increase in mitigation costs.

Christine Miloyo, who is living with bipolar disorder, is a mental health advocate and a teacher-turned product support associate in tech. She says that she has been lucky to work for supportive employers throughout her career.

“When I worked as a teacher, I was able to have mental health breaks when I needed them, and when I needed sick leave, I was given, and the best part of it all was that I was able to be linked with a resident psychologist who walked with me so that I could be able to thrive in my workplace.”

Where she works right now, Miloyo says she is glad the working hours are quite flexible, where there are days she works from the office and sometimes from home.

“On the days that I work from home, I’m able to recharge and refresh so that by the time I go back to the office, I can be productive.”

While she is lucky to have been treated well by both her employers, Miloyo says that a lot needs to be done for people living with mental health conditions to thrive in the workplace.

“Sometimes it is important not to disclose that you have a mental health condition at the workplace because you never know how your employer may perceive the situation. It could go both ways.”

Miloyo also advises people with mental health conditions to prioritise self-care even as they strive to perform well at the workplace.

“Investing in self-love and self-care will enable you to have more productive hours such that, even when you need a mental health break, your boss won’t feel that you are a liability to the organization.”

Nathan Kamau, a social-emotional learning expert and counselling psychologist, says he handles between 15 and 20 cases of mental issues resulting from workplace toxicity every six months. “Toxic environments can manifest in various forms such as bullying, micromanagement, and unfair treatment at the workplace.”

Kamau adds that each case requires personalised attention, acknowledging that more employees are seeking support thanks to the rise in awareness and information around mental health issues.

“I employ social-emotional learning techniques that help them manage stress, express their emotions constructively, and build resilience. Mindfulness and grounding exercises are also effective tools to manage emotional balance,” he adds.