A breakdown of equipment, including a CT scanner, locked an estimated 82,000 people from accessing inpatient services at Mathari National Teaching and Referral Hospital (MNTRH) during the 2024/25 financial year, according to disclosures.
MNTRH is the country's only public mental health referral centre. Traditionally an inpatient referral hospital, MNTRH has in recent years expanded to offer outpatient clinical services, including counselling and psychotherapy, pharmaceutical, physiotherapy and orthopaedics, laboratory, rehabilitative, dental and general outpatient consultations.
According to the National Treasury, inpatient admissions at MNTRH reached 228,700 against a target of 310,418 – a shortfall of 26 percent.
Outpatient attendance was 181,212 against a target of 192,453. Imaging is a critical component of psychiatric care, as clinicians must first rule out neurological and other medical conditions that can cause psychiatric symptoms.
The absence of CT and radiology services delayed the diagnostics required to discharge patients, increasing the average inpatient length of stay to 50 days, compared to the 46-day target.
The 2024 Kenya Health Facility Assessment found that only 61 percent of hospitals were equipped for effective care. An earlier audit of Level Four hospitals showed that 35 percent consistently had a functional X-ray kit.
MNTRH received Sh1.05 billion for 2024/25, despite a stated requirement of Sh3.6 billion, forcing gadget maintenance to compete with wages, drugs and basic operations.
The National Clinical Guidelines for Management of Common Mental Disorders notes that one in every 10 Kenyans has a common mental health disorder, yet services are available in just 29 of the 284 Level Four and above hospitals.
Seventeen counties have no psychiatrists, and all mentally ill persons requiring inpatient care are admitted exclusively to Mathari, regardless of severity or distance.
MNTRH treats around 64,000 inpatients every year, but has only 366 employees, or roughly 26 percent of the recommended workforce of 1,416.
The hospital received Sh1.05 billion for 2024/25 against a stated requirement of Sh3.6 billion, forcing equipment maintenance to compete directly with wages, medicines, and basic operations.
In August 2025, the government launched the National Equipment Service Programme to replace the failed Managed Equipment Services programme, a model under which the state had signed seven-year contracts in 2015 with five original equipment manufacturers to supply, install, maintain, and replace diagnostic and surgical equipment in 98 hospitals across all 47 counties.
The 2024/25 Auditor General’s report noted that inpatient numbers consistently exceed the 700-bed capacity, with patients sleeping on the floor in conditions that breach constitutional rights to health.
Daily occupancy has been recorded at between 700 and 750, placing the civil section’s bed occupancy rate at 119 percent.
Meanwhile, the 2021–2025 Mental Health Action Plan recorded that the government spends approximately 15 cents on mental health for every Kenyan each year, compared to the recommended Sh250, a fraction of what experts say is needed to deliver meaningful care.
