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Yvonne Gache: 'Mental Health Is A Social Justice Issue'

It's more than the diagnosis

BY Agnes Amondi

Oct 03, 2022, 07:50 AM

In 2020, a task force on mental health recommended that mental illness be declared a national emergency of epidemic proportions.

As per the Ministry of Health, an estimated one in ten people in Kenya suffers from a common mental disorder. That figure rises to one in every four when looking at those receiving outpatient services. 

Depression and anxiety are the most prevalent types of mental health disorders. Substance abuse follows with individuals between the ages of 18 to 29 years registering the highest casualty.
This grim reality is something that Yvonne Gache, a critical counselling psychologist at Green String Network (GSN), and also a mental health activist and advocate, knew long before the statistics hit the papers. In fact, elongating her job title from counselling psychologist to critical counselling psychologist was motivated by this very harsh reality. 
“I am a trained counselling psychologist. I changed my title to critical counselling psychologist because I realised there is much more to mental health than just diagnosis. This is a social justice issue."
“These are not just individual issues. The majority of people’s mental health distress is exacerbated by the broken systems we live in. Thus, asking a person who lives in abject poverty or someone who deals with broken systems at work and at home, to receive enough therapy so that the environment they live in no longer affects them is not only impractical but unfair.”

Keeping An Open Mind

Yvonne always knew she wanted to pursue psychology despite deviating from her preferred career early on.
“I always wanted to do psychology. However, after high school, I did a short course in computers and the teacher recommended that I pursue it further. My dad approved and I did it though I knew it was not the path I envisioned for myself. I later went back to school and studied counselling.” 
“I began my practice in a rehabilitation centre which at the time, was the starting point for most people. It was easy to get internships and demand was constant. 
"As time went by, I realised I'm passionate about working with disciplined forces and therefore, the opportunity to work on this program with Green String Network (GSN) was really timely. Having a mental health program for the police is something I had always envisioned.”
Additionally, Yvonne has experience in offering psycho-social support. She’s done this with parents and as she explained, it's familiar.

“The issues are cyclical. The same issues that plague the police are the same that other members of society face. There could be slight differences but the core issues are the same which is why I don't view the police as them. We are all in the same boat.”  

Working With The Disciplined Forces

Yvonne is a project assistant of the Mwamko Mpya program which means a new awakening. It is aimed at helping police officers deal with and process their trauma. She reflected on it.

Mwamko Mpya came about as a result of the community wanting the police to be taken through the Kumekucha programme, as they were not getting along with members of the community.

It so happened that the police loved the initiative. However, because it was designed to address the needs of the other members of the community, it didn’t speak to the specific challenges that the police faced. Thus, Muamko Mpya was started.”

“The impact was evident. What the Muamko Mpya program did was bring the officers together and broke some of the barriers that existed between officers of different ranks. 
"It humanised the disciplined forces as it gave the officers a platform to freely talk about their experiences and it changed the way the senior and junior ranking officers relate to one another.” 
This is just one of the three projects GSN runs. Kumekucha is a community program, Mwamko Mpya is an adaptation of Kumekucha designed specifically for the police.

Then there is Kumekucha Quest, a youth program tailored for 10 - 24-year-olds which looks to bring back a sense of community that’s seemingly being lost because of how our society has evolved politically, culturally and economically. Lastly, Kumekucha Virtual is an online version of Kumekucha Quest.  
All of these programmes are being anchored under the WellBeing and Resilience framework which applies a healing-centred approach that uses a trauma-informed lens to look at what ails society. 

“The idea is to bring everyone on board and build a cohesive, peaceful and loving community. It doesn’t mean that people won’t be disciplined. It just means that we will be tolerant with one another.”     

It's A Multi-disciplinary Affair

Green String Network is a peacebuilding organisation that has brought together individuals from different disciplines - psychologists, everyday people, peacebuilders, and people in administration and development - in order to come up with programs that implement peacebuilding differently. 
Yvonne explained the importance of combining people with different expertise. She also talked about the importance of employing methods like dialogue, group facilitation, and specific context-based application of trauma-informed capacity to conduct the sessions.
“You could have an expert walk in, teach and leave. The thing is, people rarely remember what experts say. The best way for adults to learn and retain information is through experiential learning. One of the things we believe in and actually do is engage people. 
"Everyone has something to offer. We have the technical skills and expertise but everyday people live and work through trauma. Instead of sitting and listening to an expert, we want them to feel like they are part of the process.”

“The reason why we use the approaches stated above is that wellness is multidisciplinary. We need to collaborate with different sectors in order to facilitate and achieve peace. 

Therefore, to be able to point out issues like trauma, chronic violence and its effects on our lives, we need a diverse approach. This also promotes inclusion and makes the process more sustainable as multiple groups get heard and their interests represented.” 
The organisation has run its programs in various places around the country namely Mombasa, Kisumu and Nairobi. She spelt out how they choose the communities to work with.
“The reason we selected Mombasa for example was because of the violent extremism and the Al Shabab recruitment that was happening primarily at the coast. At that particular time, that’s where the intervention needed to go.

"Now, there’s a great need amongst young people. Issues such as suicide and substance abuse are on the rise and we need to move fast to reduce and prevent such occurrences.”
A 2020 report by the Ministry of Health showed that the number of suicide cases rose by a staggering 58% between 2008 and 2017 with 317 suicide deaths per year, although the age group of these fatalities wasn’t stated. 
"Furthermore, we settled for areas like Majengo in Nairobi and Kwale in Mombasa because it's easier for people to trust you if you've had a relationship with them before.

We implemented the Kumekucha program in these areas so we are returning to these areas because venturing into new areas calls for us to build everything from the ground up. That's quite the challenge."

Breaking The Cycles Of Violence

One of the issues that Yvonne and the Green String Network team deal with is breaking the cycle of violence and ending blame games. This cycle occurs in three stages as Yvonne noted: 

the tension-building phase where the aggressor is irritable, the actual explosion where the violence happens and the honeymoon phase where the perpetrator seems remorseful or might act like nothing happened but can easily relapse and stay in this cycle. 

Here's Yvonne's advice to handle this situation.
“We need to realise that there’s a very thin line between the victim and the perpetrator. This is important because it presents a potential opportunity for dialogue and healing. Before we get there, we need to ask ourselves: What drives the perpetrators' actions? 
What unmet needs do they have that they feel can only be met through violence and cruelty? The moment we understand this, then we move closer to stopping the cycles of violence that are usually driven by pitting the victim against the perpetrator.”

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