CONTRIBUTORS
Daniel Mtai Mwanga
Senior Data Scientist
Elizabeth Wambui Mwaniki
Research Officer
Frederick Murunga Wekesah
Associate Research Scientist
Joan Watiri Kinuthia
Research Officer
By Simeon Kintu Paul
Adolescent mental health challenges are considered a significant global concern. Adolescents and youth frequently face challenges that affect their mental and general well-being, yet support for addressing their mental health needs remains minimal.
In their quest for psychological assistance, adolescents frequently encounter barriers such as stigma, discrimination, and inadequate referral mechanisms. These challenges often leave them without receiving the support they need, hence hindering their ability to thrive.
Why are adolescents not receiving adequate support?
In 2024, the African Population and Health Research Center launched the “Improving Referral for Adolescents with Mental Health Disorders in Nairobi” (RAMH) project. For a year, the study worked to develop a deeper understanding of the adolescent mental health ecosystem by establishing gaps in the referral pathways for adolescents with mental health disorders. The scope of work also included establishing awareness of the availability of adolescents and youth-friendly services (AYFS). The study established that in addition to knowledge gaps, adolescents also encounter barriers to accessing care due to stigma and financial constraints. The results indicate a pressing demand for accessible mental health services, informed community stakeholders, including religious leaders, and effective referral mechanisms between community stakeholders, guidance and counseling teachers, and professional mental health services providers to facilitate timely intervention.
They also highlight the urgent need for more robust mental health support systems within the communities to ensure adolescents receive timely and effective care and support. Findings from the RAMH study reveal that the stigma surrounding mental health remains a significant obstacle to seeking care and support. Many adolescents and their families hesitate to seek help due to perceived or actual societal judgment, which perpetuates fear of speaking up (and help-seeking) and neglect. Additionally, the lack of knowledge regarding the mental health issues affecting them and the available psychosocial support services means that adolescents and their caregivers often do not know where to seek help. Even when they do, the referral systems are frequently unclear, underdeveloped, or unresponsive, hence creating further delays in accessing care.
Studies show that teachers and religious or faith leaders are often the first point of assistance for many young people experiencing emotional and psychological distress. However, interviews conducted with religious leaders, guidance and counseling teachers, and resident school nurses revealed a substantial gap in knowledge and resources to address adolescent mental health challenges. This uncertainty stems from inadequate training, insufficient resources (youth-friendly centers), and a lack of clear referral pathways. These factors significantly hinder the ability of community stakeholders, guidance and counseling teachers, and professional mental health services providers to provide meaningful support to adolescents whenever they experience psychological distress.
Why collaboration is key: The role of community stakeholders
Strengthening the capacity of these ‘first-responders’ could help positively transform mental health outcomes for adolescents and society in general. For instance, faith leaders may be trained to recognize early signs of mental health challenges or psychological disorders and are equipped with the knowledge about available referral services. Ensuring community leaders have the expertise and resources to support adolescents is crucial in strengthening referral systems. Similarly, the government may establish a collaborative system where guidance and counseling teachers, school nurses, and professional mental health services providers work together to create a seamless support network. Such a collaborative approach would ensure that adolescents receive consistent and timely support, thus reducing the risk of falling through the cracks.
Recommendations for Strengthening Mental Health Referrals
Creating an enabling environment for mental health-seeking and care provision for adolescents requires the implementation of specific practical and actionable recommendations. Firstly, it is crucial to invest in training relevant community stakeholders, such as religious or faith leaders, and guidance and counseling teachers. These individuals often serve as trusted sources of support for adolescents and can play a crucial role in identifying mental health challenges early. Providing comprehensive training would equip them to recognize signs of psychological distress, offer initial guidance/support, and direct adolescents to appropriate professional care.
In addition, establishing clear and structured referral mechanisms is very important. Adolescents and their families need simple, well-defined referral pathways to navigate the system and connect with professional mental health services. Such mechanisms ease the process for those seeking help and empower community stakeholders to make timely and effective referrals.
Raising awareness within the community is another fundamental step. Public education/awareness campaigns can help demystify the stigma surrounding mental health, which often prevents adolescents and youth from seeking help/support. Such initiatives include school-based programs, media campaigns, community sensitization, and engagement with youth-focused organizations, including youth centers, to foster open discussions on mental well-being. These initiatives can foster a culture where mental health is openly discussed and prioritized, creating a safe space for adolescents and youth to reach out for help without fear of judgment.
Equally important is ensuring that mental health services are both accessible and affordable. Currently, mental health services for adolescents in Nairobi, such as youth centers, remain largely underfunded, with limited resources allocated to specialized adolescent mental health programs. Findings from the RAMH Project indicate that many existing services are not easily accessible due to financial constraints, often discouraging adolescents and their families from seeking professional care. Additionally, inadequate (or lack of) funding affects the availability of trained mental health professionals and the development of structured referral systems. Addressing these gaps requires increased budgetary allocations to support subsidized services, mental health integration in schools, and improved referral networks (pathways). Policymakers are responsible for enacting policies and allocating resources that make quality care available to all adolescents, regardless of their socio-economic background/status. These policy actions may include subsidizing services, expanding mental health coverage in insurance schemes, or increasing care availability in underserved areas.
Finally, collaboration among stakeholders is key. Partnerships between community leaders, healthcare providers, and policymakers can foster a more unified approach to adolescent mental health care. By working together, these groups can develop stronger and more responsive policies and guidelines, build stronger referral networks, and avail the necessary resources to ensure that every adolescent in need receives timely and practical support.
These collective actions address existing challenges and lay the groundwork for a more inclusive and supportive mental health system for adolescents.
A more supportive future
The future of adolescent mental health depends on collective action. By empowering community stakeholders and fostering collaboration, we can build a support network that effectively addresses the mental health needs of young people. The findings of the RAMH Project highlight the importance of a well-informed, collaborative, and resource-rich approach to mental health care.
These findings highlight the need for strengthened referral systems, increased community involvement, and better resource allocation to ensure adolescents receive timely and adequate mental health support.
Let us unite to create a community where stigma no longer silences those in need and where adolescents receive the support they deserve. Together, we can have a meaningful impact by ensuring that the health system and the community prioritize every adolescent’s well-being.
Simeon Kintu Paul is a Research Officer at the African Population and Health Research Center. A trained psychologist, his work focuses primarily on mental health research.