How a simple group therapy programme is helping depressed teen mothers in Kenya

Pregnancy and early motherhood can be challenging under any circumstances for adolescents. But in Kenya the challenges are huge. Many pregnant and parenting adolescents face stigma, interrupted education, financial hardship, strained family relationships and limited social support. These challenges can increase their risk of depression and other common mental health problems during a critical stage of life. Yet access to mental health care for this group remains limited. In Kenya, 15% of girls aged 15-19 have been pregnant and the national adolescent birth rate is 73 per 1,000 girls. Mental health specialists are scarce and services are concentrated in urban areas. Mental health support is rarely integrated into routine maternal and adolescent healthcare. Consequently, many young mothers who could benefit from support never receive it. Similar challenges are seen across many African countries. We are mental health researchers and clinicians who have spent more than a decade working with adolescents, young mothers, health workers and policymakers to improve access to mental healthcare in Kenya. In a recent paper we set out the findings of a trial that tested the effectiveness of group interpersonal psychotherapy for depression management in Kenya among 122 perinatal (pregnant or parenting) adolescents. Group interpersonal psychotherapy is an intervention conducted in primary care settings in groups. It helps people understand how their emotional well-being is influenced by relationships, social support, communication and major life changes. The trial ran both full and mini interventions. The full intervention involved eight sessions; the mini version had four. The study applied a collaborative care approach within the World Health Organization Mental Health Gap Action Programme framework for training a nonspecialist workforce, where trained nurses screened participants and supervised group sessions delivered by community health promoters collaboratively with psychologists. Participants included perinatal adolescents, aged 13 to 18 years, in their first to second trimester of pregnancy. Our findings show that the interventions reduced depressive symptoms. In the case of full treatment, results were evident within one week after the intervention. Substantial improvement occurred within the first four sessions for both arms. The findings also underscore that psychological care can be delivered effectively through primary healthcare services, even in settings where specialist mental health professionals are limited. Adolescents who participated experienced greater improvements in depressive symptoms and daily functioning than those receiving standard care. It shows that mental healthcare does not have to depend solely on psychiatrists or psychologists to achieve results. Read more: Pregnant and parenting teens in Nairobi’s informal settlements: the hidden mental toll of stigma Our research Our study enrolled 122 pregnant adolescents aged 13 to 18 years receiving care in two maternal and child health clinics in Nairobi, the capital. Participants were randomly assigned to receive either standard care, four sessions of group interpersonal psychotherapy, or the full eight-sessions programme. The intervention focused on helping participants strengthen relationships, improve communication, build social support and manage difficult life transitions. Trained lay providers facilitated the group sessions under supervision from clinical psychologists and nurses who had received training through the World Health Organization’s Mental Health Gap Action Programme. What we found The results were striking. Adolescents who received the full programme saw average depression scores fall from 12.4 at the start of the study to 2.2 after treatment – a reduction of about 83% in symptoms. Those who received the shorter version improved from 11.6 to 3.9 – a 66% reduction. Adolescents receiving standard care improved from 11.0 to 7.9, a reduction of about 28%. Put simply, young mothers who participated in the group therapy programmes experienced two to three times greater improvements in depression symptoms than those receiving standard care alone. Read more: Pregnant teens in Kenya’s low-income areas avoid health care because of fear and stigma Why these findings matter for Kenya Kenya has around 150 psychiatrists serving a population of more than 50 million people. Kenya Psychiatric Association has around 163 psychiatrists in its records and reports that most of these professionals work in urban areas. This shortage of specialist providers remains one of the biggest barriers to improving mental healthcare in Kenya. Traditional one-to-one therapy models require highly trained professionals, who are in short supply. Our findings suggest another path forward. Group interpersonal psychotherapy allows a pair of trained facilitators to support several adolescents at the same time. It can be delivered by non-specialist providers working in existing community and primary healthcare systems. It can also be integrated into maternal and child health services. The group format also offers advantages beyond the therapy itself. Young mothers often experience isolation and feel that nobody understands their circumstances. Group sessions create opportunities for peer support, shared learning and connection with others facing similar challenges. These social connections may be part of the therapeutic benefit. Kenya does aim to provide mental healthcare within maternal and child health services. Our findings offer evidence that this is possible. Moving from evidence to action The next step is ensuring that such support becomes routinely available. By building on existing health platforms rather than creating separate systems, Kenya has an opportunity to narrow the mental health treatment gap and improve outcomes for both young mothers and their children. Our study shows this can be done at scale, by allowing non-specialists to share the tasks. Other countries face similar workforce shortages and treatment gaps. The study therefore offers guidance for their policymakers and practitioners seeking practical, affordable and sustainable approaches. Moving from evidence to action will require integrating mental health into the services that pregnant and parenting adolescents already use. This approach aligns with national efforts to strengthen primary healthcare. By integrating routine depression screening, evidence-based group interventions and appropriate referral mechanisms into maternal health services, Kenya can scale up its efforts. Read more: Tricked and uninformed: why so many young girls in Kenya are getting pregnant For pregnant and parenting adolescents, this is more than a health intervention. It is an investment in education, family wellbeing, child development and future opportunity. Dr Carol Ngunu, Shillah Mwaniga, Joseph Kathono, Vincent Nyongesa and Darius Nyamai contributed to the research on which this article is based. Manasi Kumar receives funding from NIMH and Fogarty International Center and UK NIHRI Prof. Anne Obondo is affiliated to the University of Nairobi as associate professor/consultant psychiatric social worker and I have received funding for research from National Institute of Mental Health (NIMH).Caleb Othieno and Obadia Yator do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

How a simple group therapy programme is helping depressed teen mothers in Kenya

Share this report

Related Intelligence

GIZ -Tender Invitation: Delivering expert services for advancing Marine Spatial Planning and Marine Conservation in Angola

Eight arrested over railway theft

Joyce Bawah Mogtari urges women leaders to build strong support networks

Bawumia engages GUTA over import duties, VAT and rising business costs

About Us

Company

Image Post