Assessing mental health literacy of primary health care workers in Kenya: a cross-sectional survey

Helen Rawson,Fethi Mansouri,Elijah Marangu,David Ndetei,Natisha Sands,Karen Wynter,Peterson Muriithi

doi:10.1186/s13033-021-00481-z

Abstract

AimTo assess mental health literacy of health workers in primary health care services in Kenya.BackgroundMental illness is common in Kenya, yet there are fewer than 500 specialist mental health workers to serve Kenya’s population of over 50 million. The World Health Organization recommends the integration of mental health care into primary health care services to improve access to and equity of this care, especially in low and middle-income countries. An important step to integrating mental health care into primary health care services is to determine mental health literacy levels of the primary health care workforce.MethodA cross-sectional survey using Jorm’s Mental Health Literacy Instrument (adapted for the Kenyan context) was administered to 310 primary health care workers in four counties of Kenya.ResultsOf the 310 questionnaires distributed, 212 (68.3%) were returned. Of the respondents, 13% had a formal mental health qualification, while only 8.7% had received relevant continuing professional development in the five years preceding the survey. Just over one third (35.6%) of primary health care workers could correctly identify depression, with even fewer recognising schizophrenia (15.7%).ConclusionsThis study provides preliminary information about mental health literacy among primary health care workers in Kenya. The majority of respondents had low mental health literacy as indicated by their inability to identify common mental disorders. While identifying gaps in primary health care workers’ mental health knowledge, these data highlight opportunities for capacity building that can enhance mental health care in Kenya and similar low and middle-income countries.

Highlights

Mental illness is common in Kenya, yet there are fewer than 500 specialist mental health workers to serve Kenya’s population of over 50 million
As part of a wider study that assessed mental health service systems in Kenya, this paper focuses on mental health services at primary health care level and reports on the following: (a) Mental health literacy, indicated by the capability of primary health care workers to assess, recognise and respond appropriately to symptoms of common mental illnesses in hypothetical characters described in vignettes
This study revealed that primary health care workers had very low mental health literacy indicated by low diagnostic accuracy for serious and common mental disorders; only 39% of participants allocated the depression vignette correctly identified the disorder, and diagnostic accuracy was even lower for schizophrenia (24%)

Summary

Introduction

Mental illness is common in Kenya, yet there are fewer than 500 specialist mental health workers to serve Kenya’s population of over 50 million. The World Health Organization recommends the integration of mental health care into primary health care services to improve access to and equity of this care, especially in low and middle-income countries. Mental health care for people living in low and middleincome countries (LMICs) has been described as inadequate, inefficient and inequitable [1, 2]. This leads to a ‘treatment gap’, which is defined as the number of people with a mental disorder that do not receive mental health care [3,4,5]. Focusing on Kenya, this study utilised Jorm’s Mental Health Literacy survey tool to describe mental health knowledge and attitudes of the primary health care workers in four counties of Kenya

Methods

Results

Discussion

Conclusion