Outcome evaluation of psychological interventions offered to adolescents seeking mental health services at the national referral and teaching hospital in Nairobi, Kenya

Abstract

BackgroundLiterature highlights that adolescent mental health problems are amenable to treatment, specifically to psychological interventions. Unfortunately, there is a dearth of evidence on the services available for their management especially in low-middle-income contexts. This study aimed to highlight psychological interventions available to adolescents seeking mental health services at the National referral hospital in Kenya and to understand their effectiveness in the management of child and adolescent mental disorders. MethodsMaking use of a naturalistic, observational approach, we followed a cohort of adolescents (n ​= ​201) receiving talk therapy. Assessments were collected at the beginning and end of each session to assess patient outcomes and therapeutic alliance over the 12-month study period, with participants attending an average of three sessions. Analysis was carried out on the entire sample including descriptive and bivariate analyses, as well as analyses of clinical and reliable change. Sub-analysis was also carried out on a smaller sample who had a clinical diagnosis. ResultsScores on the Paediatric Symptom Checklist [M(SD) ​= ​51.1 (9.55)] showed our participants had high levels of impairment warranting further treatment. However, only 37.3% were assigned a clinical diagnosis. It was noted that the adolescents received multiple therapies. Our findings on outcome showed that there was statistically significant mean decrease in scores from intake to second follow-up on the self and clinician rated outcomes. Post hoc analysis with a Bonferroni adjustment revealed that outcome scores statistically significantly decreased from intake to second follow-up at 3.39 (95% CI, 1.61 to 5.17) on self-rated and 2.64 (95% CI, 1.38 to 3.9) on the clinician-rated scores. ConclusionOur findings illustrate mental health services, specifically psychotherapies offered to adolescents seeking care in a public institution are associated with alleviation of adolescent distress over time.