Mental health treatment in Kenya: task-sharing challenges and opportunities among informal health providers

Christine W. Musyimi, Victoria N. Mutiso, David M. Ndetei, Isabel Unanue, Dhru Desai, Sita G. Patel, Abednego M. Musau, David C. Henderson, Erick S. Nandoya, Joske Bunders

The study was conducted to explore challenges faced by trained informal health providers referring individuals with suspected mental disorders for treatment, and potential opportunities to counter these challenges. The study used a qualitative focus group approach. It involved community health workers, traditional and faith healers from Makueni County in Kenya. Ten Focus Group Discussions were conducted in the local language, recorded and transcribed verbatim and translated. Using a thematic analysis approach, data were entered into NVivo 7 for analysis and coding. Results demonstrate that during the initial intake phase, challenges included patients' mistrust of informal health providers and cultural misunderstanding and stigma related to mental illness. Between initial intake and treatment, challenges related to resource barriers, resistance to treatment and limitations of the referral system. Treatment infrastructure issues were reported during the treatment phase. Various suggestions for solving these challenges were made at each phase. These findings illustrate the commitment of informal health providers who have limited training to a task-sharing model under difficult situations to increase patients' access to mental health services and quality care. With the identified opportunities, the expansion of this type of research has promising implications for rural communities.