Patience Makwele
The approval of Namibia’s new Mental Health Bill (Bill 8 of 2025) by the national council has been welcomed as a major shift towards a more dignified and accessible care, raising questions about how the reforms will reach patients in regions where basic mental health infrastructure remains lacking.
This comes after national council member Olivia Hanghuwo said none of Ohangwena’s hospitals have a dedicated mental health facility, ward or unit, leaving patients to travel to Oshakati Intermediate Hospital for treatment.
She stressed that the journey can be exhausting for families, particularly those coming from remote parts of the region, saying the “journey starts as far as Okongo.”
“Getting there, however, does not necessarily mean getting a bed.”
Hanghuwo said the Oshakati facility is often full, leaving some patients back in the care of their families, who may struggle to manage their conditions without professional support.
Ohangwena also has no dedicated rehabilitation centre for patients who need continued care after treatment.
The situation, she said, leaves families dealing with a mental health crisis with few options beyond travelling to another region, waiting for space or taking the patient home.
“Some patients need ongoing rehabilitation and follow-up, but in Ohangwena we do not have a dedicated rehabilitation centre,” Hanghuwo said.
She said the new legislation should also bring clarity to how patients are managed and discharged after treatment, while protecting their safety and dignity.
Hanghuwo further stressed the need for qualified personnel to be available across the health system, including schools, clinics, health centres, hospitals and mobile clinics.
“Schools, clinics, health centres, hospitals and mobile clinics need sufficient qualified personnel, especially when it comes to young people,” she said.
The concerns come as the government prepares to move from the 1973 Mental Health Act to the new framework.
Deputy minister of health and social services (MoHSS) Susan Hambelela Ndjaleka, in her statement on the conclusion of the national council’s deliberations, said the ministry had already started the process of promulgating regulations under the new legislation.
She said the ministry would also constitute and resource the review boards provided for under the bill.
“We have commenced the process of promulgating regulations, we will constitute and resource the review boards, and we will carry mental health care into all 14 regions,” Ndjaleka said.
She, however, warned against expecting the legislation alone to fix the country’s mental health system.
“A law is a promise, not a service,” she said.
The deputy minister said the law would not automatically “build a ward in Rundu, place a psychiatric nurse in Opuwo” or open a day-care centre in Katima Mulilo.
Meanwhile, national council member Piniel Pakarae said mental health would remain difficult to address if it did not receive a meaningful share of the health budget.
He called for at least 5% of the health budget to be allocated to mental health services.
“Funding is the lifeblood of implementation. Without adequate resources, the most progressive legislation will remain an aspiration,” Pakarae said.
Pakarae also called for a national mental health register to track cases, suicide rates and treatment outcomes, with the information made public annually.
“We need to know how many people are affected, where they are, what treatment they receive and whether they recover,” he said.
He further proposed a free, 24-hour national mental health helpline operating in multiple languages, as well as mandatory mental health programmes in schools from Grade 6.
Another national council member, Wenzel Kavaka, pointed to the situation in rural constituencies such as Otjombinde, where families often carry the burden of mental illness with little support.
“In Otjombinde, families are carrying this burden with very little support, information or access to care,” Kavaka said.
He said the shift towards community-based treatment would only work if rural communities were included in the rollout of services.
The concerns are not happening in isolation. Ministry figures presented during the national council proceedings showed that 365 suicide attempts were recorded in Ohangwena between April 2024 and June 2025.
The national council passed the Mental Health Bill without amendments on 28 August, after Namibia had operated under the 1973 law for 53 years. The bill has now been referred to President Netumbo Nandi-Ndaitwah for consideration.
Questions sent to the Ohangwena regional health directorate regarding the absence of dedicated mental health facilities and rehabilitation services in the region, as well as the number of patients being referred to Oshakati, were not answered by the time of publication.
