IMPROVING REFERRAL FOR ADOLESCENTS WITH MENTAL HEALTH DISORDERS IN NAIROBI: A PILOT STUDY

Recent findings from the Kenya National Adolescent Mental Health Survey (K-NAMHS) show that over two-fifths (44%) of adolescents in Kenya experienced a mental health problem in the past 12 months, yet only 11% sought services for emotional and behavioural problems. Among those who sought help, 34% turned to religious or faith leaders, while 32% sought support from school staff. Very few consulted doctors or nurses (10%). While some mental health conditions can be adequately addressed by religious leaders and school teachers through counselling, others require specialised treatment and care in mental health facilities. For example, psychiatric and neurological conditions such as epilepsy, schizophrenia, and psychosis need specialist intervention. However, in Kenya, there is no clear referral pathway linking religious and faith leaders with clinical services for such conditions.
The general objective of this study was to determine the acceptability of establishing referral pathways between religious/faith leaders, school teachers/resident nurses, and professional mental health services in Nairobi. The specific objectives were:
(i) To identify barriers and facilitators of adolescent referrals from religious leaders and secondary school teachers/resident nurses to professional mental health providers or facilities; and
(ii) To identify mental health services and facilities in Nairobi City County as well as the existing referral services.
The study was conducted in Nairobi County using a mixed-methods approach. We carried out key informant interviews with Nairobi mental health service focal persons and in-depth interviews with religious/faith leaders, secondary school nurses, and guidance and counselling teachers. Quantitative methods were also employed to abstract data from facilities offering mental health services in Nairobi County. Data abstraction was conducted through interviews with the Nairobi County mental health department. Qualitative data were analysed deductively using a pre-specified framework and inductively to incorporate emerging factors identified by respondents. Quantitative data were analysed descriptively and summarised in tables.