Multiple mental health studies presented at the just concluded Kemri annual scientific and health conference concur on the imperative of expanding targeted and demographic specific mental health interventions in addressing disparities in mental health access in Kenya.
Several studies done in the Kenyan setting showcased the need to rapidly scale up mental health care to address escalating disability by incorporating more inclusive, systematic and strategic manner in order to bridge mental health treatment gaps.
According to a set of presentations for the mental health session at the just concluded 14th KEMRI annual scientific and health conference (KASH), there is a wide gap in mental health treatment access that could potentially benefit from a renewed multisectoral approach that would involve human resource for health capacity building especially for non-mental health specialists at the primary healthcare facilities to scale up care access.
The studies also recommend targeted interventions which include designing solutions for groups susceptible to common mental health disorders and triggers like intimate partner violence such vulnerable groups include; Gay, Bisexual, and other men who have sex with men (GBMSM) and Adolescent Girls and Young Women (AGYWs).
According to a Sequential, Multiple Assignment Randomized Trial (SMART) for non-specialist treatment of common mental disorders in Kenya: Leveraging the Depression and Primary Care Partnership for Effectiveness-Implementation Research (DAPPER) there is strong evidence on why the country should increase capacity of non-specialists at the primary care clinics to deliver mental health care to patients with depression and/or post-traumatic stress disorder.
Presenting the SMART DAPPER study, Dr Linnet Ongeri a KEMRI CCR researcher said that the study sought to examine the effectiveness of SMART-DAPPER psychotherapy by looking at interpersonal Psychotherapy (IPT) provided by non-specialists and antidepressant medication: Fluoxetine, a Selective Serotonin Re-uptake Inhibitor (SSRI) provided by Nurses and Clinical Officers.
The study reveals that non-mental health specialists can be trained to deliver globally accepted standards of psychotherapy and pharmacotherapy such as administering modern antidepressants like fluoxetine available in Kenya.
It further reveals that mental health treatment for key local disorders such as depression and trauma disorders like (PTSD) can be effectively delivered with integration of mental health screening and treatment for the most prevalent.
The study also reveals that populations seeking primary care in Kenya have high prevalence of Major Depressive Disorder (MDD) (26 percent) and posttraumatic stress disorder (PTSD) (35percent) while minimally adequate mental health treatment is received by only 3.7 percent of individuals with major depression and 2.3 percent of those with anxiety, including trauma-disorders.
In another study by Kargeno research hub done by Vincent Salano, George Otieno, Fredrick Otieno, Imelda Wakhungu, Mercelline O. Onyando, Maricianah Onono which sought to evaluate the association between intimate partner violence (IPV) and common mental disorders (CMD) Among Gay, Bisexual, and other men who have sex with men (GBMSM) community in Kisumu, Kenya, reveals that intimate partner violence (IPV) has a profound impact on mental health, with higher rates of common mental disorders (CMD) among victims.
The study uncovered the prevalence, frequency, and risk factors of IPV within this marginalized community, addressing a significant gap in understanding the challenges faced by GBMSM.
According to the study GBMSM experience stressors while lacking social support which may heighten the effect of harmful events such as intimate partner violence (IPV) on mental health outcome.
“Urgent action is needed to develop comprehensive strategies for IPV prevention and support within the GBMSM community,” the study recommends.
The study calls for future research to delve deeper into the nuanced interplay of demographic, behavioral, and mental health factors to inform targeted interventions.
While another study by Kargeno research hub presented by Denis Kegode, looking at the effect of Pregnancy Intendedness on Maternal Attitude, Adjustment, and Bonding Post-Pregnancy among Adolescent Girls and Young Women (AGYW) in Southwestern Kenya, found out that absence of intention for a pregnancy had an adverse effect maternal attitudes towards sex and maternal-infant bonding among AGYWs.
The study found out that parental stress and depressive symptoms is associated with unintended pregnancy, could negatively affect maternal attitudes towards their partner, and lead to impaired mother-infant bonding.
“Targeted contraceptive counselling during antenatal and postnatal clinics will help reduce the rate of unintended pregnancies,” the study revealed.
The study recommends identifying adolescents with unintended pregnancy and supporting them to access appropriate antenatal and delivery services that will enhance maternal-infant bonding and the child health outcomes.
While Nita Claris Akech presenting a study titled The Role of Social Support on Mental Health among Parenting Adolescent Girls and Young Women: A nested Cross-sectional Study in South-western Kenya revealed that high social support significantly lowered the severity of common mental disorders (CMDs) among AGYWs.
The study suggests that in order to navigate the complex intersection of adolescence and parenthood, a robust support network is crucial to their well-being. The study also recommends finding advocate for targeted interventions to enhance social support thus improving mental health outcomes for AGYWs.
