Mental health and psychological well-being of Kenyan adolescents from Nairobi and the Coast regions in the context of COVID-19

Abstract

Background Despite the high burden of mental health problems during adolescence and its associated negative consequences, it has remained neglected especially in sub-Saharan Africa. The 2019 novel Coronavirus disease (COVID-19) pandemic has placed additional stress on adolescent mental health. However, there are few studies documenting the burden of mental health problems and even fewer mental health services in the region. In relation to the limited body of knowledge, the present study aims to determine the psychological well-being of adolescents and to assess the risks and associated factors of mental health problems among adolescents in the context of COVID-19 pandemic in Kenya. Methods We conducted a cross-sectional survey in 2022 among adolescents aged 13–19 years living in Nairobi, and the Coast region of Kenya. We utilized standardized psychological assessment tools including the Patient Health Questionnaire, Generalized Anxiety Scale, Strengths and Difficulties Questionnaire, The World Health Organization- Five Well-Being Index Scale, and the Pandemic Anxiety Scale, to evaluate the psychological wellbeing of the adolescents. A linear regression model was used to evaluate the correlates associated with quality of life, pandemic anxiety, and emotional and behavioural problems among adolescents. Subsequently, a logistic regression model was used to assess factors associated with depression and general anxiety disorders. Variables with a p-value < 0.25 in the univariate model were included in the multivariable regression model. Results The results are based on 797 participants who met the inclusion criteria. We found the prevalence of depression to be relatively higher among out-of-school adolescents at 36.0% compared to school-going adolescents at 20.6%. Furthermore, out-of-school adolescents had significantly higher anxiety scores when compared to their school-going counterparts (27.7% vs 19.1%) respectively. In-school adolescents had a better quality of life scores, lower pandemic anxiety scores, and lower emotional and behavioral problems scores compared to their out-of-school counterparts. Key risk factors associated with depression include; being out-of-school (OR = 1.96 (95% CI 1.33- 2.88) p-value = 0.001), loneliness (OR = 10.68 (95% CI 4.49–22.86) p-value < 0.001), and living in an unsafe neighborhood (OR = 2.24 (95% CI 1.52–3.29) p-value < 0.001). An older age (OR = 1.16 (95% CI 1.03–1.30) p-value = 0.015), being out-of-school (OR = 1.81 (95% CI 1.19–2.77) p-value = 0.006), and living in an unsafe neighborhood (OR = 2.01 (95% CI 1.33–3.04) p-value = 0.001 were key factors associated with anxiety. Furthermore, key factors positively correlated with quality of life include; high socioeconomic status (ß (Std.Err) = 0.58 (0.14) p-value < 0.001, talking to friends often (ß (Std.Err) = 2.32 (0.53) p-value < 0.001, and being close to parents (ß (Std.Err) = 1.37 (0.62) = 0.026. Conclusion Our findings imply that mental health support services targeting adolescents in the country should be prioritized, especially for those who are out-of-school.

Understanding the need for pediatric neurodevelopmental services among households in western Kenya: A population-based study

“…These findings are consistent with previous measures of mood disorders among children and adolescents in Kenya, which ranged from 14% in 2015 18 to 19.1%–26% during the COVID-19 pandemic. 19 Unfortunately, services to support these children are severely limited, especially in LMICs. 20 , 21 Improved health programming is needed to meet the mental health needs of children within this setting.…”

Experiences of Lockdown During the Covid-19 Pandemic in the Mental Well-Being of the Uninfected Population in the Post-Pandemic Era at Marist International University College in Nairobi, Kenya.

“…Following the initial revelation of COVID-19 cases in Kenya in March 2020, the government implemented a lockdown in multiple regions, including Nairobi, the country's capital, by April. Both non-essential enterprises and schools were shuttered (Mbithi et al, 2023).…”

“…In addition, the government restricted public gatherings, including weddings, funerals, and religious ceremonies, and instituted a curfew at night (Mbithi et al, 2023). These actions had a profound effect on the populace, resulting in a large number of individuals losing their jobs, having their incomes cut, and having trouble getting basic necessities (Osborn et al, 2022).…”

“…The nation's schools didn't return until January 2021. The school closures also affected the education of millions of pupils, generating concerns about the long-term effects on their academic development (Mbithi et al, 2023).…”

“…According to Loades et al ( 2020), a comprehensive study of 83 studies, there was a high correlation between mental health problems and the length of loneliness experienced during the COVID-19 pandemic. The review states that loneliness and social isolation raise the risk of anxiety and depression (Mbithi et al, 2023). There have also been shown to be positive associations between social isolation and risky behaviours related to eating disorders, self-harm, and suicidal thoughts (Loades et al, 2020).…”