Namibia's Mental Health Bill: Challenges in Implementation Discussed

While Namibian mental health data is limited. Available statistics show that more than 91 500 outpatient mental health consultations and 11 400 inpatient admissions and 542 deaths were reported in the 2023-2024 fiscal year alone. The applause that greeted Namibia's new Mental Health Bill in June this year may have marked an important turning point for mental healthcare in the country. But behind the legislative milestone lies a less comforting reality: the professionals expected to deliver mental healthcare say the system remains severely stretched, with too few specialists, inadequate resources, limited community-based services and a heavy dependence on a single specialised facility in Windhoek. For psychiatrists and psychologists working on the frontline, the problem is no longer simply about whether Namibia has the right law. Keep up with the latest headlines on WhatsApp | LinkedIn It is whether the country has the people, facilities, funding and support systems needed to make that law work. Dr Lahija Hamunjela, a specialist psychiatrist, knows the pressure first-hand. In an interview with New Era last week, Hamunjela revealed that the shortage of psychiatrists has placed enormous pressure on the country's mental health services, with specialists forced to juggle multiple responsibilities while patients can wait days, weeks or even longer before receiving specialist attention. "For instance, apart from attending to the patients at the hospital, the two psychiatrists have to attend to forensic psychiatric patients both in Windhoek, Oluno and Gobabis," Hamunjela said. The consequences, she said, are felt by both patients and healthcare workers. "The system has also created anger among those who are mentally ill as in some cases it takes a week, if not a month, for a psychiatrist to attend to them," she said. A system carrying more than it was built for Namibia's mental health burden is substantial, yet specialist services remain concentrated in a small number of locations. The Mental Health Care Centre at Windhoek Central Hospital is the country's main specialised psychiatric facility. Although designed to accommodate about 200 patients, it has at times carried a significantly heavier burden. Hamunjela says Namibia needs more trained psychiatrists and stronger multidisciplinary teams, as well as decentralised services that would reduce the dependence on Windhoek. "Oshakati only has a ward allocated, not a stand-alone facility as in Windhoek," she said. She believes Namibia must move beyond a system in which specialist mental healthcare is concentrated in the capital. "There is a need for more trained and certified psychiatrists," Hamunjela said. "We need to work as a multidisciplinary team, which includes decentralisation from only Windhoek and Oshakati hospitals." The problem begins before the patient reaches the psychiatrist The shortage is not only about the number of psychiatrists. Dr Manfred Janik, a medical doctor and a senior lecturer in Psychology and Social Work at the University of Namibia, says Namibia must distinguish between a shortage of trained professionals and a shortage of professionals employed within the public health system. "In psychology, for example, there are psychologists and psychological counsellors who are qualified but struggle to find positions in the public sector," Janik said. "The problem is, therefore, partly one of inadequately funded posts and uneven deployment rather than simply an absence of trained professionals." Psychiatry, however, presents a different challenge. Janik says Namibia has historically had limited local capacity for specialist training in psychiatry. Although psychiatry is taught to medical students and postgraduate and training capacity is being developed, the country still needs specialist academic staff, clinical training sites and supervision capacity. "The result is a difficult cycle. There are too few specialists. The available specialists become overburdened. Work