Moving Beyond ‘A white Man’s Thing’: A Case Study of Urban Kenyan Youth Mental Health

Abstract

Background: Kenya is a lower middle-income country located in Eastern Africa with a population of over 54 million people and a median age of 20 (World Bank, 2020). Competing health emergencies, a healthcare infrastructure ill-prepared for crisis, and inconsistent framing of mental health in culturally relevant terms have all created a gap between mental health need and services in Kenya (Meyer & Ndetei, 2016). This study explores how 15–24-year-olds in Nairobi, Mombasa and Kisumu counties define their mental health and which resources and barriers impact their engagement with mental health services. This study was designed to contribute to the ongoing REACH-MH (Reaching, Engaging Adolescent and youth adults for Care Continuum in Health-Mental Health) project. Methods: I used an inductive approach to answer two research questions: 1) How do adolescents/young people (AYP) define their mental health? and 2) How do relevant stakeholders describe resources and barriers to AYP mental health? For this case study focused on LVCT Health’s One2One program, I used five sources of data: in-depth qualitative interviews with One2One hotline counsellors; One2One hotline data; youth focus group transcripts; stakeholder meeting notes; and government document review of the Mental Health Taskforce Report of 2020 and the Mental Health Amendment Act of 2022. Findings: Five themes emerged from the data regarding the universality of “stress” as a concern for youth, the common conflation of mental health and mental illness, and recommendations for youth-friendly provision of mental healthcare. Overwhelmingly, study participants defined “mental health” in ways that captured broader social determinants of health, along with descriptions of “emotional, psychological and social wellbeing”. Barriers to mental health included cost and a lack of trust in mental health professionals, while youth’s capacity for coping and knowledge of the few, but existent, community services available were reported as facilitating factors. Conclusions: Though challenges abound, also numerous are the strengths and resources possessed by Kenya’s people who continue to solve problems and utilize ways old and new to strive toward a uniquely Kenyan conceptualization of mental health.