Innovation summary

Despite the higher education sector in Kenya growing immensely in one generation, the development of pastoral and support services has not taken place at the same pace. There is little provision to support students experiencing mental health problems. Research in Kenyan government universities has identified high levels of depression and anxiety among students, especially the many students from poor backgrounds1. Mental health conditions can and do cause students to leave higher education, meaning that they aren’t able to reach their potential.

This project will develop core mental health support services in University of Kenyatta and University of Chuka to provide vulnerable students with prevention and support services whilst attending the university. Many of these students have come from extremely poor communities, and the pressure for them to achieve is immense. By offering mental health support services we aim to educate, support and treat students who are vulnerable and at risk of developing mental illness through the following services:

  1. Access to treatment including clinical and low intensity psychosocial therapies
  2. Health promotion including behaviour change and communication skills
  3. Peer support services
  4. Anti-stigma services
  5. Technology leverage

Impact summary

  • 805 beneficiaries utilized psycho-social therapies from the program.
  • Improvement in Knowledge, Attitude and Practice score reported in 60% of staff who had been trained in brief psychological interventions.
  • Improvement in Knowledge, Attitude and Practice score in 40% of the students in relation to stigma.

“We are really grateful to the project. We are receiving referrals from the different faculties in the university which is different from before when such students would automatically get suspended from studies or even expelled due to substance use and addiction.”

Sarah – A Wellness Centre Staff.

Innovation details

Rates of mental health problems are higher among students from lower socioeconomic backgrounds, and higher overall in poorer countries; research in Kenyan universities identified high levels of depression and anxiety among students1. Researchers also found depressive symptoms in over 40% of students at the University of Nairobi, including severe cases in 5.6% (5.3% males and 5.1% female)2.  Kenyatta University student welfare centre highlight that mental health problems often cause students to leave higher education, meaning that they aren’t able to reach their potential; yet the university mental health support services are poor, and staff and student awareness of mental health problems is low.

The Innovation aims to:

  • Access to treatment and psychosocial support via a combination of traditional core mental health services as well as low intensity psychotherapy.
  • Providing proactive health promotion and reactive substance misuse services.
  • Establishment of safe spaces.
  • Establishment of support systems through peer support groups consisting of students and staff members with experience of mental distress.
  • Anti-stigma publicity campaigns and use of role models.
  • Leverage technology for behaviour change: setting up ‘hackathon’ event and social media advocacy.

Key drivers

Innovative approaches

  • Using means that appeal to students such as theatre, art, music and social media to effectively increase knowledge and influence practice e.g. leveraging technology through a hackathon involving students to develop software solution(s) to improve access to student mental health services.
  • All this is in line with the mantra “Nothing about us without us”.

Lived experience leadership 

  • University students with lived experience of mental health problems lead in the awareness creation activities. They are trained to become mental health advocates and recruit others in promoting wellbeing in the university.

Utilising existing structures for service provision

  • Working with the University Wellness Centre and Dean of Student Affairs and building their capacity to institutionalize support services for students’ mental wellbeing.

Holistic approach in campaigns

  • The anti-stigma campaigns and the awareness initiatives involve a diverse array of faculties and departments in the university.
  • Student leaderships and the various clubs are also actively involved increasing their level of ownership in the program

Inclusivity

  • The initiatives and developments are all suited to fit all types of students and staff.
  • Persons Living with Disability and Persons Living with Psycho-social Disability are both highly considered in the establishments, planning and campaigns in the universities.

Challenges

Interruptions to the academic calendar

  • Student unrest and demonstrations led to closure of one of the universities for some time thus affected the roll out of some of the health promotion campaigns and general objectives in time.
  • Moreover, students in public universities typically have a 6-month long break in which activity implementation in the program has to be halted.

Time constraints for uptake of services

  • Referring students to the rehabilitation centres during the semester conflicts with their semester schedule. As a result, some students limit their participation in the detox programmes to resume classes, which may lead to high likelihood of relapse.

High rates of burnout

  • More students are now coming forward for support as is reported amongst the mental health advocates and the student counsellors due to the increasing awareness of mental health care from the program’s campaign. Referral rates have since increased to the student wellness centre but the numbers of staff remain the same.

Continuation

Duplication of the model in higher education institutions in the country: Evaluation of the project will hopefully show cost-effectiveness that will be used to make a case not only to the 2 institutions in particular, but also to all public universities in Kenya.

This model will prove that mental health and wellbeing is a concept worthy of attention and investment. This combined with the peer-pressure that will likely be created within the student body will help to positively shift thinking within the higher education establishment.

Partners

  1. Christian Blind Mission United Kingdom (CBM UK)
  2. Christian Blind Mission Kenya (CBM Kenya)
  3. Centre for Assessment, Psychotherapy and Research (CAPRE) Kenya
  4. Amazing Minds Africa Kenya
  5. Ember Mental Health

Funders

  1. Nous Cims Foundations

Evaluation methods

Baseline and End Line Survey/KAP survey

  • A strong learning component to the project will include baseline data collection, mid-point assessment and end evaluation, including prevalence service use with disaggregation by socioeconomic status and gender.
  • It will draw heavily on the strengths of students themselves using highly participatory approaches to assess factors related to the effectiveness and appropriateness of interventions to build on the limited knowledge base about what works in improving mental health and wellbeing among students in Kenya.
  • All learning will be captured and shared freely and widely to advance understanding, including an open-access published final project learning report.

Use of Screening Tools

  • Mental Health assessments to track depression, suicidality, substance use and other prevalent wellbeing challenges of those seeking psychotherapeutic services.

Indicator Matrix

  • Documenting numbers of those reached through training, awareness creation events, service delivery and on social media advocacy.

Cost of implementation

The program runs on a budget of USD $330,111 for a total of 2 years with the first year almost completed.  It is very cost effective as we have exceeded some of the annual targets set, with a few months left to completion of the first year into the program.

Impact details

Increased Capacity Building:

  • 103 educationists/university staff have been trained in case detection, mental health first aid and referral.
  • 218 peer leaders have been trained on detection and administering mental health first aid, and using social media as a tool for advocacy and quality rights on mental health.

Increased mental health care in the university:

  • 805 students are receiving psycho-therapeutic interventions in one on one sessions; groups support systems and buddy groups which are peer facilitated support groups.
  • Indoor safe spaces have been established in both target universities: Kenyatta University and Chuka University.
  • 9 students have been referred to rehabilitation centres for detoxification programs and psychiatric care.

Increased mental health awareness in the university/anti-stigma campaigns:

  • 8,850 promotional materials have been distributed amongst the university students and staff.
  • Fresher’s events for the newly admitted students have been held in both universities with a reach of 7000+ students in both universities. The events are aimed to spread awareness on care for well-being among the students.
  • World Mental Health Day was marked by a procession led by a band and mental health advocates in the program, spreading awareness on suicide prevention around the community and university at large.
  • 709 students have been reached through forum theatre and psychodrama which are led by mental health clubs in the two universities.

Active social media advocacy:

  • The project hashtag #NotOkayIsOkay has recorded 523,418 followers and engagements championing for mental health care and awareness on twitter, trending on various occasions at top 4.

References

  1. Othieno CJ, Okoth RO, Peltzer K, Pengpid S, Malla LO. Depression among university students in Kenya: Prevalence and sociodemographic correlates. Journal of affective disorders. 2014 Aug 20;165:120-5.
  2. Othieno CJ et al. 2014 Depression among university students in Kenya: Prevalence and sociodemographic correlates. Journal of affective disorders. 2014: 120-125.

Research

Tools

Multimedia

Reports

Associates

Khira Geoffrey Project Manager
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Country

Kenya

Affiliated organizations

CBM

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