Project Lead(s): David Ayuku
An estimated 10–20% of youth suffer from mental health disorders and, in developing countries, mental healthcare services are scarce. For example, in Kenya there are 0.19 psychiatrists per 100,000.
To treat a child or youth with mental health issues, one must treat the family, as individual interventions are not sufficient because family conflict is often among the root causes of symptoms.
This project developed and delivered a novel family therapy intervention in low-resource communities in Kenya by empowering faith and village leaders – those who are already sought out by community members to help with family conflict and children’s mental health concerns – to be the providers.
Specifically, the project team carried out the following activities:
· Created an intervention based on simplified, but proven, family therapy strategies that were adapted for Kenyan culture and local practices – the intervention was called: Tuko Pamoja (“We are Together” in Kiswahili) and a manual outlining the 10-step process was developed.
· Developed a mobile phone-based technology support tool to provide multi-media support to the counselors.
· Trained lay counselors to provide the family therapy.
· Conducted a pilot study using quantitative and qualitative methods to assess:
o Implementation Outcomes: how successful was the lay counselor model?
o Clinical Outcomes: did participating families experience changes?
· Held workshops to develop scale-up models with 29 church administrators and local leaders, resulting in ideas for sustainable, large-scale dissemination through churches in Kenya.
A total of 14 lay counsellors were recruited and trained. They subsequently enrolled a total of 14 families (36 individuals) from their communities. These included 12 adolescents and 23 caregivers.
A mixed method evaluation was then conducted.
In an evaluation of the 14 families, both caregivers and children reported positive effects and specific ‘real-life’ examples of changes they experienced.
Changes were reported in the following domains: overall family functioning, parent-child relationships, marital relationship quality and individual mental health.
As a result of this project, the team obtained additional funding for related work at Moi through partners at Duke University.
The project allowed the team to formalize collaboration with the Eldoret Pastors’ Association and the administration of the Africa Inland Church, one of the largest denominations in the country.
The project team plans to scale up this innovation to 30 churches across the country and to carry out a randomized controlled trial. Currently, they are seeking transition-to-scale funding.