Depression among pregnant and parenting teenagers in Kenya is a significant concern, with many facing stigma, interrupted schooling, and financial strain.
Now, findings from a clinical trial in Nairobi suggest that a structured group therapy programme delivered by non-specialist health workers can substantially reduce depressive symptoms in this vulnerable group.
The research, conducted by a team of mental health clinicians and researchers, tested the effectiveness of group interpersonal psychotherapy (IPT) among 122 pregnant or parenting adolescents aged 13 to 18.
The participants were recruited from two maternal and child health clinics in the capital and were randomly assigned to receive either standard care, a four-session version of the therapy, or the full eight-session programme.
In a report on the trial’s findings, the authors explain that group IPT is an intervention that helps people understand how their emotional well-being is shaped by relationships, social support, communication, and major life changes.
The sessions were facilitated by trained lay providers, with supervision from clinical psychologists and nurses who had received training through the World Health Organization’s Mental Health Gap Action Programme.
The results showed marked improvements. Adolescents who completed the full eight-session programme saw their average depression scores fall from 12.4 at the start of the study to 2.2 after treatment, a reduction of about 83%.
Those in the shorter, four-session version improved from an average score of 11.6 to 3.9, a 66% reduction. In comparison, adolescents receiving only standard care improved from 11.0 to 7.9, a reduction of about 28%.
Our research
The authors note that substantial improvement was evident within the first four sessions for both intervention groups, and for those in the full treatment arm, results were apparent within one week after the intervention concluded.
The study also found that participants in the therapy groups experienced greater improvements in daily functioning than those receiving standard care.
What we found
The trial’s context is a nation with a severe shortage of mental health specialists.
Kenya has around 150 psychiatrists serving a population of more than 50 million people, and the Kenya Psychiatric Association reports that most of these professionals work in urban areas.
This scarcity is a major barrier to care, as traditional one-to-one therapy models require highly trained professionals who are in short supply.
Why these findings matter for Kenya
The findings suggest that group IPT offers a viable path forward. A pair of trained facilitators can support several adolescents at once, and the therapy can be delivered by non-specialist providers working within existing community and primary healthcare systems.
The group format also provides benefits beyond the therapy itself, creating opportunities for peer support and connection among young mothers who often experience isolation.
The authors argue that by building on existing health platforms, Kenya has an opportunity to narrow the mental health treatment gap.
They suggest that integrating routine depression screening, evidence-based group interventions, and appropriate referral mechanisms into maternal health services could allow the country to scale up its efforts.
The study’s approach, they add, could also offer guidance for policymakers in other countries facing similar workforce shortages and treatment gaps.
Moving from evidence to action
Dr Carol Ngunu, Shillah Mwaniga, Joseph Kathono, Vincent Nyongesa and Darius Nyamai contributed to the research on which the report is based.
Source: The Conversation