Registration KPA Secretariat

Project Tujiimize: A Community-Driven, Design Thinking–Informed Approach to Adolescent Cannabis Use Prevention in Kisumu County, Kenya (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Benjamin Wafula (Uzima University)

**Background:** Cannabis use among adolescents is a growing public health concern in low-resource settings, including Kisumu County, Kenya. Early initiation is often linked to peer pressure, media influence, and limited mental health education. Project Tujiimize was launched as a community-driven initiative to assess patterns of adolescent cannabis use and co-design locally appropriate, youth-informed interventions. The project aims to: (1) assess prevalence, risk factors, and perceptions of use; (2) identify education gaps and support systems; (3) implement youth-preferred strategies for prevention; and (4) empower parents and teachers to support students affected by cannabis use. A Design Thinking framework was used to explore the problem space and guide future intervention development. **Methods:** A cross-sectional survey was administered to 98 students across two urban high schools in Kisumu County, with three additional schools planned to reach a target sample of 250. Participants included 83 males, 14 females, and one respondent who preferred not to disclose their gender. The structured questionnaire collected data on demographics, cannabis exposure and motivations, perceptions of harm, and preferred prevention strategies. Findings will inform the design of school-based interventions, peer mentorship programs, and parental engagement efforts. **Results:** Most respondents (73.5%) were aged 15–17, and the majority (83.7%) reported never having used cannabis. Among users, reported consequences included poor academic performance, anxiety, memory issues, and encounters with law enforcement. Peer pressure was cited as the primary driver of use (91.8%), followed by emotional distress (26.5%) and curiosity (12.2%). Initial cannabis information most commonly came from media (51%), followed by schools (30%), friends (24.5%), and family (4.1%). Awareness of cannabis-related harms was high, especially regarding mental health effects (70.8%), addiction (64.6%), academic performance (47.9%), and criminal risk (33.3%). A family history of substance use was reported by 54% of respondents. Students expressed strong preferences for prevention through counseling services (65.2%), school-based education (26.1%), parental involvement (23.9%), and to a lesser extent, law enforcement (15.2%). Schools were identified as the most trusted source of information (81.6%). **Discussion/Conclusion:** The results highlight both the vulnerabilities and resilience of adolescents in Kisumu County regarding cannabis use. While many students reported never using cannabis and expressed strong disapproval of it, a subset face direct exposure and adverse outcomes. Community-based, school-centered interventions aligned with student-identified needs, such as counseling and peer support, show strong potential for impact. Design Thinking proved useful in exploring the social and structural drivers of cannabis use, and will be used to iteratively refine intervention content and delivery based on student feedback. Expanding Project Tujiimize across schools, while maintaining its participatory, locally grounded framework, could meaningfully contribute to improved adolescent mental health and substance use prevention in similar contexts.

Evaluating the role of Chiromo Hospital Group's social media presence in enhancing technology and mental health innovations for community-based care (Technology and Mental Health: Innovations for Community-Based Care)

• Gathoni mbugua (Chiromo Hospital Group)

BACKGROUND Recognizing the pervasive reach of social media, Chiromo Hospital Group, through the Digital Relations Department in 2018, embarked on a deliberate strategy to leverage these platforms to address the significant treatment gap for mental health services. The initiative’s primary focus was to promote mental health advocacy through social media and community-based interventions. The core objectives of the project were to enhance mental health awareness and literacy, combat stigma associated with mental ill health, improve access to care through online platforms, foster community-based support, and drive innovation by integrating technology to understand community health needs. An evaluation of Chiromo Hospital Group's use of social media may reveal a significant positive impact on enhancing mental health technology and fostering innovative community-based care models. METHODS The evaluation involved a retrospective descriptive design which included a qualitative analysis of social media content and a review of the hospital's official reports for the year 2024. The source of data was Chiromo Hospital Group official social media accounts and hospital internal reports for the year 2024. RESULTS The hospital's social media platforms have amassed a significant reach, with high levels of engagement on posts related to mental health awareness and literacy, destigmatization, and service accessibility. The overall reach of its social media platforms for the year 2024 was 629000 with men forming a majority of the population at 55.4%. The overall engagement for the same period was 30308. The table below showcases reach and engagement per platform.   PLATFORM REACH ENGAGEMENT X 173400 (27.5%) 7100 (23%) Facebook 155400 (24.7%) 8100 (26.3%) Instagram 139700 (22.2%) 8700 (28.2%) Linkedin 89500 (14.2%) 3500 (11.4%) Tiktok 22000 (3.5%) 808 (2.6%) Youtube 49000 (7.8%) 2600 (8.4%) TOTAL 629000 30808 The integration of online booking systems has demonstrably lowered the barriers to seeking professional help. However, we lack specific data on conversion from reach to engagement to referral. The consistent and empathetic messaging on social media has contributed to a more informed and less stigmatizing public conversation around mental health in Kenya. The hospital has also been able to leverage data from its social media interactions to tailor its content and services to be more responsive to community needs. CONCLUSION Chiromo Hospital Group's strategic use of social media platforms is a transformative force in the delivery of mental healthcare in Kenya. This may serve as a case study for other mental healthcare institutions and providers in the region, demonstrating the immense potential of social media in bridging the mental health treatment gap and fostering a culture of mental wellness. Use of social media as mental health experts may also ensure quality control and regulation are crucial in addressing potential dangers and misinformation in social media and healthcare. The continued integration of digital innovations remains a key pillar of Chiromo's vision for the future of mental healthcare in Africa.

Enhancing Psychosocial Wellbeing and ART Adherence: The Critical Role of Peer Navigators in Supporting Adolescents with HIV in Western Kenya (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• GLADYS ONTUGA (KENYA MEDICAL RESEARCH INSTITUTE)

Adolescents and young adults living with HIV (AYAH)face intersecting psychosocial challenges that significantly impact their mental wellbeing and adherence to antiretroviral therapy (ART). Despite growing global emphasis on improving ART adherence, there is a notable gap in intergrating psychosocial wellbeing into HIV care particurlaly in resource-constrained settings like Kenya. Peer navigation, delivered by trained individuals with lived experience has emerged as a promising strategy to bridge this gap by offering emphatic contextual relevant support. This study aimed to explore how peer navigation may support the wellbeing of AYAH in Western Kenya A qualitative approach was employed, utilizing in-depth interviews (IDIs) with Peer Navigators(N=9) and AYAH who received peer navigation(N=20) in an ongoing clinical trial. The semi-structured interview guide explored themes related to emotional support, stigma, mental health, ART adherence behaviors, and the navigator-participant relationships. The Capability, Opportunity, Motivation – Behaviour (COM-B) provided a framework to examine how peer navigators and AYAH perceived the intervention’s impacts on wellbeing. Findings revealed that peer navigators’ capabilities were significantly strengthened through structured training giving them the ability to address key psychosocial well-being challenges faced by AYAH including stigma, disclosure, and intimate partner violence (IPV), enabling them to provide targeted support. They said that ongoing mentorship, debriefings, and collaboration with families and healthcare teams enhanced their ability to provide consistent, empathetic support . In turn, peer navigators supported AYAH in terms of improved emotional regulation, communication, self-management, and clinic attendance. Peer navigators reported that the intervention fostered self-efficacy among AYAH, helping them to manage health-related challenges, reduce internalized stigma, and increase ownership of their care. Peer Navigators reported that both electronic (phone-based) and in-person peer navigation sessions offered an opportunity to provide AYAH support. However, in-person session was felt to be more in-depth. Despite barriers like limited finacial resources, participant relocation, communication, and gender dynamics which occasionally disrupted opportunities to provide the intervention, peer navigators remained adaptable. AYAH reported that the intervention provided the opportunity to have a safe, non-judgmental space that encouraged open discussions, as well as feeling understood and less alone resulting in reduced stigma. While some participants appreciated the inclusion of family members for added support, others preferred private sessions due to concerns about stigma and confidentiality Both navigators and AYAH reported that motivation was developed through the establishment of strong, trusting relationships between navigators and AYAH. AYAH reported that peer navigation contributed to positive identity transformation and empowerment. Nonetheless, concerns regarding confidentiality, particularly related to facility identification and phone-based communication, emerged as challenges requiring creative strategies to maintain trust Overall, findings underscored the pivotal role of peer navigation in delivering intergrated psychosocial wellbeing tailored to unique needs of AYAH. Through the lens of COM-B framework, it became evident that enhancing individual capability, enabling opportunities and sustaining instinsic motivation are essential for promoting behaviour change. Embedding peer-driven strategies that address the overall wellbeing of AYAH offers a promising pathway to improve health outcomes and support the psychosocial needs of of this population. Authors declare no commercial interests related to this study

Question And Answer Q&A by a moderator

Dr. Edith Kwoba Memorial Walk Flagging off - Nawiri Walk Keynote Address from the NEC and Guests, Dr. Florence Jaguga

POSITIVE DEPRESSION SCREEN AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT AGA KHAN UNIVERSITY HOSPITAL, A CROSS SECTIONAL STUDY (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Michael Maina (Aga Khan)

ATTACHED

THE UNSEEN TOLL:THE PREVALENCE OF DEPRESSION,BURNOUT AND PTSD AMONGST HUMANITARIAN AID WORKERS IN KAKUMA AND DADAAB REFUGEE CAMPS (Trauma and Resilience in Conflict-Affected Communities)

• Brenda Ombane (Chiromo Hospital Group)

THE UNSEEN TOLL:THE PREVALENCE OF DEPRESSION BURNOUT AND PTSD AMONGST HUMANITARIAN WORKERS IN KAKUMA AND DADAAB REFUGEE CAMPS. BACKGROUND: The 21st century has seen a dramatic increase in global humanitarian crises, doubling the number of people in need to 360 million in the last decade. This surge far outstrips available resources, placing immense pressure on humanitarian aid workers who operate in inherently dangerous, volatile, and unpredictable environments. The mental health and resilience of humanitarian aid workers is directly intertwined with the well-being and resilience of the conflict-affected communities they serve. If aid workers are struggling with trauma, burnout, and depression, their capacity to effectively support the community's healing and resilience building is compromised. Understanding the mental health burden on these frontline providers is critical for community mental health. This study aimed to determine the prevalence of depression, burnout, and PTSD, and their associated factors, among humanitarian aid workers delivering healthcare services in Kenya's Dadaab and Kakuma Refugee camps. METHODS: This study utilized a cross sectional quantitative design amongst 124 humanitarian aid workers, employing a census survey to collect data. Data collection involved a researcher-designed socio-demographic questionnaire and adaptations of established psychometric tools: the Beck Depression Inventory (BDI) for depression, the Maslach Burnout Inventory (MBI) for burnout, and the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5) for PTSD. Ethical approval was granted by the KNH –UON ERC.This robust methodology provides a foundation for evidence-based integration of mental health support within humanitarian operations. RESULTS: Psychometric analyses showed that 31% of respondents had depression, with 19% experiencing severe depression. For PTSD, 41% were above the cut-off score, suggesting they could benefit from further assessment and treatment. Burnout analysis revealed that 7% had high emotional exhaustion, 77% had high depersonalization scores, and all 124 respondents had high scores for personal accomplishment. The study revealed a significant number of humanitarian aid workers providing healthcare to refugees suffer from depression, PTSD, and burnout. Key contributing factors identified included high staff turnover, heavy workloads, stressful shifts, lack of supervisor support, and poor mental health-seeking behavior. These findings underscore the critical need for proactive mental health interventions. The high prevalence of these conditions among aid workers has direct implications for the sustainability and effectiveness of humanitarian efforts, impacting not only the aid workers themselves but also the resilience of the communities they serve. CONCLUSION: Understanding the mental health landscape of aid workers is crucial for designing more effective, sustainable, and humane humanitarian interventions in conflict zones. Investing in aid worker well-being is an investment in the long-term recovery and resilience of affected communities. The delineation of these determinants and patterns of depression, burnout, and PTSD among humanitarian aid workers in Dadaab and Kakuma refugee camps is crucial. The study's findings provide a clear mandate for innovation in developing and implementing targeted programs and policies aimed at mitigating the incidence and progression of these disorders. By identifying effective modalities of management, we can ensure humanitarian aid workers remain safe and effective providers of essential care. This is vital for strengthening community mental health initiatives in the 21st century, ensuring the integration of mental health support into humanitarian aid systems, and ultimately enhancing the impact of their life-saving work on vulnerable populations. .

Peer-Led Support Groups to Improve Depression, Anxiety, and Self-Esteem Among Teen and Single Mothers in Kisumu County, Kenya: A Longitudinal Multi-Site Study (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Benjamin Wafula (Uzima University)
• Sarah Atieno Ouma (Tinada Youth Action Africa)

**Background/Aims:** Teen and single mothers in Kenya face disproportionate mental health burdens, including elevated rates of depression, anxiety, and low self-esteem. Access to culturally responsive and sustainable support remains limited, particularly in resource-constrained settings. We evaluated the effectiveness of a peer-led support group intervention in reducing symptoms of depression and anxiety and improving self-esteem among teen and single mothers in Kisumu County, Kenya. **Methods:** We employed a longitudinal, multi-site design across seven sub-counties in Kisumu County. Community members underwent a structured training to become peer facilitators and led support groups twice monthly for five months. Eligible participants were teen mothers (ages 14–19) or single mothers (ages 20–35) who screened positive for moderate-to-severe depression (PHQ-9 ≥15) or anxiety (GAD-7 ≥10). Participants were recruited through community outreach and local health services. Data were collected at four time points: baseline (pre-intervention), mid-intervention (after 5 sessions), post-intervention (after 10 sessions), and three months post-intervention. Validated instruments included the PHQ-9, GAD-7, Rosenberg Self-Esteem Scale, Perceived Social Support Scale, and Perceived Stress Scale. Linear mixed models were planned to assess changes over time. Ethical approvals were obtained from Maseno University, NACOSTI, and Duke University. **Results:** A total of 77 participants (mean age: 25 years) were enrolled from all seven sub-counties; however, due to logistical constraints, the intervention was only implemented in five sub-counties. At baseline, the mean PHQ-9 score was 21.7 (95% CI [19.9, 23.5]) and at endline, 21.2 (95% CI [19.5, 22.9]). For anxiety, the mean GAD-7 score decreased from 18.2 (95% CI [17.2, 19.4]) at baseline to 16.6 (95% CI [15.4, 17.9]) at endline. Full statistical analyses, including linear mixed models, are ongoing and will be presented at the conference. **Conclusions:** This study explores the potential of peer-led mental health interventions in low-resource settings. Preliminary findings suggest a modest reduction in anxiety symptoms, with minimal change in depressive symptoms. Further analyses will assess potential moderators and mediators of treatment response, as well as secondary outcomes including perceived stress, perceived social support, and self-esteem. At the conference, we will present finalized results and discuss policy and programmatic implications. Community-driven, culturally grounded peer support groups may represent a promising and scalable approach to address the mental health needs of adolescent and single mothers in Kenya.

Voices from the Frontline: Mental Health Realities of CHWs in Kenya’s Evolving Health System- Findings from a Qualitative Study (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Patricia Okoth (LVCT Health)

**Background:** Community Health Workers (CHWs) are vital in bridging informal and formal health systems, enhancing access to underserved populations. Despite their essential roles, they often contend with heavy workloads, limited structured support, and inconsistent compensation. While existing research has focused on their responsibilities, few studies have examined their lived experiences, particularly on their mental well-being (MWB). This multinational collaborative study seeks to explore CHWs’ personal and work experiences and how these influence their mental well-being in urban and rural settings. The findings will support the co-design of context-specific interventions and inform policy recommendations. **Methods:** In Kenya, the study engaged 27 CHWs (16 F, 11 M) from two contrasting settings: informal settlements in Nairobi County and rural communities in Kiambu County. Individual and work experiences were explored using Life History Interviews to explore their current motivations, stressors, and coping behaviours, and how these influenced their MWB. Participants also created life history maps to visually represent their lived experiences. All interviews were conducted in local languages, audio-recorded, translated, and transcribed verbatim. Data were analysed using the Framework Approach with the aid of NVivo 12 software. The life history maps were examined through content analysis to identify common themes. All participants provided written informed consent. Ethical approval for this study was granted by AMREF Ethics and Scientific Review Committee (Protocol number: ESRC P1472/2023). **Results:** CHWs identified several motivators that contributed to their engagement, including the recent introduction of stipends, provision of branded attire and kits, and increased community recognition. However, participants also reported a range of stressors affecting their mental well-being. These included compassion fatigue stemming from repeated exposure to familiar trauma, such as grief, gender-based violence, and child abuse. CHW also experienced intrahousehold challenges such as intimate partner violence and family conflicts resulting from financial difficulties. Notably, CHWs highlighted the absence of formal debriefing mechanisms or mental health support within the health system. In response, many relied on informal support systems, including peers, family members, and friends, to cope with overwhelming situations. **Conclusion:** The mental well-being of Community Health Workers is shaped by both their professional responsibilities and repeated exposure to personal and community-level trauma. Although recent reforms such as the provision of stipends and formal recognition of CHWs mark important progress in Kenya’s health system, these alone are insufficient. There is an urgent need for the Ministry of Health and county governments to integrate mental health support into community health programming. This includes mental health literacy, ensuring access to supportive supervision through regular debriefing, counselling on trauma and self-awareness, and field-based check-ins, as well as building CHWs’ capacity in income-generating activities. Additionally, creating safe and structured forums for CHWs to reflect on and address work-related stressors will be critical to strengthening their resilience and improving the quality and sustainability of service delivery. **Acknowledgement And Disclaimer** This research was funded by the NIHR150232 using UK aid from the UK Government to support global health research. The views expressed in this abstract are those of the author(s), not necessarily those of the NIHR.

“Identity-as-Prevention”: A Community-Led Parenting Model for Early Mental Health Intervention in Kenya (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Benjamin Mutuku (Beracah Wellness Services)

In the 21st century, identity is no longer just a social concept—it is a psychological infrastructure. Children today face unprecedented challenges: digital overload, cultural disconnection, peer pressure, and performance-based validation. In Kenya, the 2021 Mental Health Taskforce Report revealed a surge in childhood emotional distress, often rooted in weakened self-concept, low self-worth, and a lack of cultural grounding. Meanwhile, UNICEF estimates that 7 in 10 children globally struggle with identity-related issues—placing them at higher risk for anxiety, depression, and poor decision-making in adolescence. Despite this, identity-building is rarely addressed in mainstream mental health prevention. Most interventions arrive after symptoms have escalated, and few are designed for or led by caregivers in low-resource community settings. To address this gap, we introduce The Identity Series: A 7-Day Intentional Parenting Challenge—a culturally responsive, low-cost, community-based mental health tool for children aged 5–12. This model equips parents to become the child’s first mental health promoters by guiding identity development through structured daily conversations and creative play. Each day focuses on a different pillar of identity: name and story, affirming language, cultural roots, personal strengths, core values, resilience through failure, and vision for the future. Rooted in developmental psychology, attachment theory, and African cultural wisdom, the model reclaims parenting as a central site of prevention. Preliminary outcomes from pilot groups in Kenya show improved emotional expression, stronger parent-child bonds, increased pride in cultural heritage, and enhanced resilience in children. This paper proposes the “Identity-as-Prevention” model—an upstream intervention framework that decentralizes mental health, placing it in kitchens, classrooms, and community spaces, not just clinics. The Identity Series addresses four major gaps: (1) the timing of intervention (early vs. reactive), (2) the underutilized role of parents and communities, (3) the absence of culturally grounded mental health tools in African contexts, and (4) the lack of scalable, simple frameworks for prevention. In a rapidly shifting world, children must know who they are before the world tells them who to be. This model reframes identity not as a soft skill but as a powerful foundation for lifelong mental wellbeing.

Question and Answer Moderated by Dr. Irene Machua

The End of Poverty Mental Health: Designing needs-relevant evidence-based Community Mental Health Services Prof. Atwoli Lukoye

Keynote address by Ms. Hyaline Morara CEO ~ Kamili Organization

Question and Answer Moderator

Opening ceremony by Dr. Phillip Kirwa Chief Executive Officer of Moi Teaching and Referral Hospital (MTRH)

Plenary session -Navigating the Labyrinth: Ethical and Legal Challenges in Contemporary Psychiatric Practice Kevin Othero - Lawyer Dr. Njuguna Simon - Consultant Psychiatrist Dr. Sylvia Kemunto - Consultant Psychiatrist Dr. Mercy Karanja - - Consultant Psychiatrist

Royal College of Psychiatrists Prof Mohammed Al-Uzri

KPA AGM KPA Members

Registration KPA Secretariat

Piloting Community-Centric Employment and Housing Solutions for Long-Stay Mental Health Patients at Mathari National Teaching and Referral Hospital (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Milcah Olando (MATHARI NATIONAL TEACHING AND REFERRAL HOSPITAL)

Background: Abandonment and prolonged hospitalization of patients in mental health facilities is a significant yet under-researched issue in Kenya’s mental health system. At Mathari National Teaching and Referral Hospital—the largest mental health facility in the country—a considerable number of patients remain admitted for extended periods, not due to clinical need, but because of abandonment by families, lack of social support, legal complications, or systemic gaps in discharge and community reintegration mechanisms. This phenomenon presents multiple challenges: it strains already limited hospital resources, compromises the quality of care for both long-stay and newly admitted patients, and violates the rights and dignity of affected individuals. Furthermore, long-term institutionalization may lead to social isolation, loss of functional independence, and worsening mental and physical health outcomes. Addressing this gap is essential for improving patient autonomy and reducing institutional dependency as well as improving efficient use of limited mental healthcare resources. Objective: This pilot program aims to develop and implement a comprehensive model that supports long-stay patients in MNTRH hrough sustainable employment and community-based housing solutions. Methodological Approach: MNTRH in a multi-stakeholder collaboration with a community based MH rehab team from Parivartan Trust (India) and mental health researcher from NYU (USA), a pilot initiative that evaluates needs and readiness to change program and policies has been undertaken. The methodological approach involves: (1) establishing skill-building and employment initiatives in partnership with local businesses and cooperatives, and (2) piloting transitional and independent housing models, including halfway homes and (3) carrying out rapid feedback and evaluation loops with these teams. The implementation is supported by staff training, ongoing mentorship, patient-centered planning, and regular monitoring and evaluation. Expected Outcomes: The pilot seeks to reduce long-term inpatient stays, enhance patient quality of life, and demonstrate a replicable model for community reintegration. Key outcomes include functional employment for patients, establishment of housing units tailored to varying levels of autonomy, and strengthened multi-sectoral collaboration. Conclusion: This initiative would provide pointers towards what may be a scalable model for deinstitutionalization and recovery-oriented care in Kenya, promoting dignity, inclusion, and long-term wellbeing for individuals with severe mental illness.

Before the Breakdown: Community-Driven Early Mental Health Support for Africans in Diaspora (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Charlene Gumbo (Chiromo Hospital Group)
• Zawadi Kimari

Before the Breakdown: Community-Driven Early Mental Health Support for Africans in Diaspora Background Humanity has been migrating for a wide range of reasons since antiquity. More than 200 million Africans have formed a community in the diaspora in pursuit of academic and professional advancements, services within international agencies or seeking humanitarian aid encounter a convergence of stressors, including cross-cultural adjustments, identity fragmentation, systemic discrimination, cultural dislocation, work and academic pressures. Despite functional competence, many experience psychological distress and functional trauma. Systemic blind spots and stigma around mental health within immigrant populations impede mainstream interventions. Aim 1.To explore clinical patterns of psychological distress among African immigrants 2.To explore barriers to accessing culturally informed mental health care services in the host country 3.To develop culturally sensitive strategies that leverage community- and peer-driven interventions for early reduction of mental health difficulties. Methodology The study was undertaken using a mixed-methods design drawing on 100 anonymised clinical cases from consultations involving African diaspora youth and professionals reviewed between January and April 2025 at Chiromo Hospital Group (CHG) via both in-person and telepsychiatry services. Cases were identified through: 1.Direct review of consultation records from the selected time frame 2.Focused discussions with the attending clinicians on cases that exhibited functional trauma characteristics Included cases were (a) clients of African origin residing abroad; (b) aged 16–45; and (c) had at least one session between January–April 2025. Excluded were clients currently residing in Kenya, or those whose records lacked sufficient detail for thematic coding. Results Several key themes emerged: Masked distress: Participants presented with anxiety, mood instability, attention difficulties, and somatic symptoms. These were often misdiagnosed or minimized due to their high-performing external presentation. Delayed help-seeking: Participants expressed reluctance to engage services due to cultural stigma, visa fears, and lack of trust in host country systems. Isolation and fragmentation: Emotional disconnection and cultural dissonance were especially pronounced among students and young professionals. Systemic mismatch: Diagnostic models in host countries often failed to recognize culturally coded expressions of distress. Conclusion This exploratory study underscores the hidden emotional load carried by African migrants. It underscores the urgent need for preventative, community-driven mental health approaches that resonate with the lived experience of transition and cultural complexity. CHG has established foundational infrastructure, including: the application of telepsychiatry, diaspora-focused psychoeducation, virtual CME programs to build capacity for culturally attuned care and piloted virtual support groups. It has taken initiative to partner with stakeholders including the ministry of foreign affairs and diaspora affairs, Kenya. Future directions include a community co-design for service provision encompassing promotive to curative care, thus facilitating scalable, sustainable peer-informed systems for diaspora communities. Ethics This project was compliant with CHG’s internal protocols. Declaration of interest All authors declare that they have no conflict of interest to disclose.

Dr. Edith Kwobah Memorial Lecture Prof. Atwoli Lukoye

Youth and School Mental Health Project: A Model for Strengthening Adolescent Mental Health Support in Kenyan Schools (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Faith Njiriri (AMPATH)

Background: Adolescents in Kenya face increasing mental health challenges, including academic stress, peer pressure, and socio-economic hardship, compounded by stigma and low mental health literacy. This prevents early detection and timely intervention for mental health problems. To address this gap, Moi Teaching and Referral Hospital (MTRH) and AMPATH, through the Afya ya Akili Mashinani (AYAM) program, implemented a teacher-led, curriculum-based school mental health model that integrates mental health education into existing school programs, builds teacher capacity, and strengthens referral linkages to care. Methods: We implemented the program in five phases: (1) curriculum adaptation, (2) program implementation, (3) teacher-led curriculum delivery, (4) follow-up, and (5) linkage to care. We adapted the African School Mental Health Curriculum through a participatory process into eight modules covering stigma, mental disorders, and counselling skills. Using a Trainer of Trainers (ToT) model, we trained teachers to deliver the curriculum in schools. We conducted sensitizations in schools and in the community, targeting students, teachers and non-teaching staff. We measured outcomes through attendance records for the teachers' training and sensitization sessions, the number of trained teachers actively delivering the curriculum, students reached and referrals for mental health care. Results: The program engaged 48 schools, reaching 24,309 students, 8,126 parents, 1,486 teachers and non-teaching staff, and 18,093 community youth through sensitizations. 835 teachers were trained, with 24 schools actively delivering the curriculum. Between July 2024 and March 2025: 12,302 students attended curriculum-based lessons, 4,564 students participated in group counselling, 156 students received one-on-one counselling and 30 students were referred for mental health care. Schools tailored delivery of the curriculum to fit their programs. Integrating the content into guidance and counselling sessions and life skills classes. Teachers reported greater confidence in addressing mental health problems, while students showed improved literacy and increased willingness to seek help. Strengthened school counselling services and referral pathways enhanced access to care. Conclusion: This teacher-led, curriculum-based model is feasible, acceptable, and effective in improving adolescent mental health literacy, early identification, and access to care in resource-limited settings. It offers a scalable, sustainable approach to adolescents' mental health and demonstrates a need for continued investment in school-based mental health interventions.

Pilot Project: Group-Based School Intervention for preventing and addressing Substance Use. (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Emmanuel Oloo (AMPATH Kenya)

Background: Youth and adolescents who use alcohol and other drugs can experience negative consequences that usually cause adverse effects on their physical, psychological, and social functioning. Direct impacts include psychiatric morbidities, poor academic performance, and behavioral problems such as misconduct at home and in school, as well as engagement in risky behaviors like reckless sexual activity. Indirectly, substance use also affects families of adolescents through conflicts, financial strain, and disrupted relationships, and affects peers through normalized risky behaviors. A study by Kurui and Ogoncho in 2019 in Kenya found that contributors to use in the context of adolescents include peer pressure, curiosity, and seeking fun. Training programs have shown promise in equipping lay providers to deliver effective interventions and enhance the capacity of teachers to support students (Substance Abuse Treatment, 2025). Incorporating life skills training, such as managing peer pressure and mental health, is recommended to enhance their impact (Substance Abuse Treatment, 2025). Methods: To address this burden, we are currently implementing a pilot care program in a secondary school in Uasin Gishu County, Eldoret, under the Academic Model Providing Access to Healthcare (AMPATH), a consortium of Moi University, Moi Teaching and Referral Hospital, and North American universities. We have partnered with Parents Teachers Association representatives, the Ministry of Health, the Ministry of Education, school heads, and curriculum review professionals in Uasin Gishu County to implement and oversee the project. Central to this initiative is the formation of substance use peer support groups in schools, led by trained teachers using a 10-session school-based substance use intervention manual aimed at educating, promoting well-being, and fostering recovery among students in school. It contains topics on education about substance use, life skills training, motivational interviewing, relapse prevention skills, and linkage to individual care. The program is delivered weekly during the guidance and counselling sessions by trained teachers. To adopt a school-led approach and refine the model before scaling, the project is being rolled out in phases. Results: Each school has unique needs in terms of available resources and infrastructure required to support the program. In the secondary school where the first phase of the pilot project was launched in 2024, three support groups with a total of 56 students were formed and were facilitated every week during clubs’ time by trained teachers. The students who had registered with the club showed a lot of interest and commitment to the program by attending the sessions even without teachers having to follow up. The administration has also shown support by not punishing students who are involved with the club and by allocating time for the program. Conclusion: Most adolescents in Kenya between the ages of 15 and 19 years spend significant time in school. Teachers are therefore uniquely positioned to support students with substance use and related issues. Training programs show promise in equipping teachers to become lay providers in delivering effective interventions and enhancing their capacity to support students (Substance Abuse Treatment, 2025).

Emerging trend of patient abandonment in an acute psychiatric ward, with a focus on community mental health as a possible solution (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Robina Momanyi (MTRH)

Background: Patient abandonment in psychiatric wards is concerning, especially in resource-limited settings where the mental health workforce and bed capacity is inadequate. This results in congestion at the wards due to an increased number of discharge in patients, patient abscondment after long stays, staff burnout due to increased workload and a strain on the hospital budget. Contributing factors for patient abandonment include stigma surrounding mental illness; intensive caregiver burden and its effect on their quality of life; patients' impulsive, disorganized or disruptive behaviors that make caregiving challenging and their violent behavior compromising family safety; and socio-economic factors given the high cost of living and treatment costs. Systemic factors including lack of a well co-ordinated mental health care service in Kenya, and a community resource database threaten the success of re-integration efforts. Some of the patients lack identification documents, making home tracing and re-patriation challenging. This report thus highlights an emerging trend of patient abandonment at an acute psychiatric ward at a level 6 referral hospital in Kenya. Objective: The broad objective is to highlight the challenge of patient abandonment, the management and home tracing of abandoned patients, re-integration back to the community and best practices and lessons learnt through the process. Methods: Descriptive case reports done at Moi Teaching & Referral Hospital (MTRH). For inpatient management of patients with severe mental illness, MTRH has a psychiatric ward, a transitional skills training home, and an Alcohol and Drug Abuse Rehabilitation center with bed capacities of 80, 16 and 40 beds respectively. Outpatient services include the emergency mental health services and two outpatient clinics. Data was collected from patient records and supplemented from departmental case summaries of home tracing and repatriation. Results: A summary of three patients who were abandoned by their families having given up hope of finding them. Two of the patients are male and had an average stay of seven years at the hospital while one is female and stayed for about one year. All were successfully reintegrated to the community after repatriation. Some of the interventions that worked included stay in the transitional home that provided structure and the services provided like skills training for economic empowerment, Illness Management and Recovery (IMR) for them to understand their illness, coping skills, and importance of medication; home tracing by social work team for re-integration; family psychoeducation and community sensitization at Barazas to reduce stigma and structured follow up post discharge for up to one year. Community focused strategies that worked included mentorship to nearby peripheral health facilities, and use of community resources like community health volunteers (CHVs). Conclusion: Potential interventions for patient abandonment in psychiatric wards need to focus on community mental health as a possible solution. Transitional homes are beneficial in bridging the gap between psychiatric wards and community re-integration. A multi-sectoral approach is recommended to address this complex issue.

Increasing access to Mental Health services by Capacity Building and Community Integration: Insights from Kilifi County, Kenya (Community-Driven Prevention, Promotion and Early Intervention in Mental Health.)

• Ann Tatu (Psychologist)

Background Kilifi county faces a growing mental health burden, with only 0.6% (12,000 cases) of its 1.7 million outpatient workload diagnosed with mental health conditions, clearly indicating significant under diagnosis. Mental health services in Kilifi County have long been limited by limited personnel, poverty, stigma, inadequate funding and political goodwill. To address this, a targeted initiative focused on building mental health capacity among healthcare providers (HCPs) and community members, while establishing effective community-level screening, referral, and follow-up mechanisms. Objective To strengthen Kilifi’s mental health system through structured training and continuous capacity building of healthcare providers and integration of mental health into primary care aimed at improving early identification, support, and referral for individuals with mental health needs. Methodology Beginning in early 2024, deliberate and ongoing efforts were implemented to build the capacity of healthcare providers in mental health care. In addition, 66 healthcare providers and 51 community members were trained using a newly developed mental health manual. The focus areas included: • Mental health screening at facilities (Depression/ Anxiety screening Majorly). • Psychological First Aid (PFA) • Basic counseling and communication skills • Community based psychoeducation through outreaches. • Mental health referral, documentation and linkage systems. These efforts were supported by county health leadership and aligned with broader system reform goals. Results • Mental health screening numbers significantly increased between 2023 and 2024, demonstrating the combined effect of formal training and continuous capacity building: PHQ-9 screenings rose from 5,293 in 2023 to 25,749 in 2024 (a nearly 5-fold increase). GAD-7 screenings rose from 4,866 in 2023 to 30,005 in 2024 (a more than 6-fold increase). Newly screened individuals also increased sharply: PHQ-9 from 165 to 679, and GAD-7 from 137 to 757. • Screening tools were successfully integrated into routine service delivery at health facilities and documentation was also enhanced using registers. • Referral pathways and care linkage improved, with the average time from screening to referral reducing by an estimated 65%, enabling faster access to specialized psychological care. • 87% of trained healthcare providers reported sustained use of skills learned, actively applying psychological first aid, screening tools, and peer support strategies. • The initiative contributed to a cultural shift, as evidenced by increased self-reporting and help-seeking behavior across key and vulnerable populations, including adolescents, women, and persons living with HIV. Conclusion This initiative highlights that mental health system strengthening in resource-limited settings requires not only one-time training, but intentional, continuous capacity building, institutional support, and strong community engagement. The model implemented in Kilifi County demonstrates how local health systems can sustainably expand access, reduce stigma, and embed mental health within primary care.

Question and Answer Moderator

Keynote Speaker by Dr. Frank Njenga Chairman ~ Chiromo Group Hospital

ECSAPsych updates Dr Priscilla Makau

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