Mental Health & Wellbeing

Executive Summary

The Mental Health & Wellbeing Program is a comprehensive, multi-sectoral initiative designed to address the growing burden of mental health conditions in Kenya. Launched in 2025, this flagship program represents UWRA's commitment to placing mental health at the center of the public health agenda and ensuring that evidence-based mental health interventions are accessible to all, especially the most vulnerable and marginalized populations. The program recognizes that mental health is not merely the absence of mental illness but a state of wellbeing in which every individual realizes their potential, can cope with the normal stresses of life, work productively and fruitfully, and contribute to their community. Mental health is an integral part of health and wellbeing and is fundamental to the achievement of sustainable development goals.

The program is grounded in a thorough understanding of the epidemiology of mental health conditions in Kenya, where depression, anxiety, substance use disorders, and post-traumatic stress are prevalent yet largely untreated. It recognizes the profound and far-reaching consequences of untreated mental health conditions, including increased morbidity and mortality, reduced economic productivity, strained relationships, and diminished quality of life. The program adopts a holistic, systems-oriented approach that addresses the multiple determinants of mental health — biological, psychological, social, and environmental — while also tackling the pervasive stigma and discrimination that prevent people from seeking help and accessing care.

Working across four counties in Kenya, the program combines direct mental health interventions with community mobilization, stigma reduction, health systems strengthening, and policy engagement. It is implemented in close partnership with county health departments, community-based organizations, mental health advocacy groups, academic institutions, and international partners. The program is designed to be scalable and replicable, with a robust monitoring and evaluation framework that enables continuous learning and adaptation. By building mental health literacy, strengthening mental health services, and fostering supportive environments, the program aims to improve mental health and wellbeing for individuals, families, and communities across the country.

Background & Rationale

Mental health conditions represent a significant and growing public health challenge in Kenya and across Africa. According to the World Health Organization, mental disorders account for a substantial proportion of the global burden of disease, and this burden is disproportionately borne by low- and middle-income countries. In Kenya, the prevalence of mental health conditions is estimated to be high, with depression, anxiety, and substance use disorders being among the most common. The burden is further compounded by the mental health impacts of poverty, inequality, violence, conflict, and displacement, as well as the psychological toll of climate change and other environmental stressors.

Despite the magnitude of the problem, mental health receives a fraction of the health budget and attention that it deserves. Mental health services are underfunded, understaffed, and largely concentrated in urban areas, leaving rural and marginalized populations with little or no access to care. The mental health workforce is grossly inadequate, with few psychiatrists, psychologists, and mental health nurses serving the population. Mental health is often not integrated into primary health care, and mental health literacy is low, with widespread stigma and discrimination that prevent people from seeking help. The legal and policy framework for mental health is also weak, with outdated legislation and insufficient implementation of existing policies.

The COVID-19 pandemic has further exposed the fragility of mental health systems and the urgent need for investment in mental health and wellbeing. The pandemic has exacerbated existing mental health challenges and created new ones, including increased rates of depression, anxiety, and post-traumatic stress, as well as the mental health impacts of social isolation, economic hardship, and bereavement. The Mental Health & Wellbeing Program is designed to address these challenges by generating evidence, building capacity, and implementing interventions that strengthen mental health systems, reduce stigma, and promote mental health and wellbeing for all.

Program Objectives

The program is guided by a set of clear, measurable objectives that address the multiple dimensions of mental health and wellbeing.

Program Components

The program is organized around five interconnected components that address the multiple dimensions of mental health and wellbeing.

Component 1: Mental Health Systems Strengthening

This component focuses on strengthening the capacity of health systems to deliver quality mental health services. It includes training health workers on the identification, management, and referral of mental health conditions; the integration of mental health into primary health care; and the establishment of community mental health services. The component supports the development and implementation of clinical guidelines, protocols, and referral pathways for mental health; the strengthening of supply chains for psychotropic medications and essential mental health commodities; and the improvement of mental health information systems. It also works to ensure that mental health services are accessible, affordable, and acceptable to all populations, including those in remote and underserved areas.

Component 2: Stigma Reduction and Community Mobilization

This component focuses on reducing stigma and discrimination associated with mental health conditions. It includes community mobilization and awareness campaigns that challenge myths and misconceptions about mental health; the engagement of people with lived experience as advocates and champions; and the development of materials and resources that promote positive attitudes toward mental health. The component works with schools, workplaces, religious institutions, and community groups to create supportive environments where people feel safe to seek help and disclose their mental health condition. It also addresses structural stigma, including discriminatory policies and practices that exclude people with mental health conditions from education, employment, and other opportunities.

Component 3: Mental Health Literacy and Promotion

This component focuses on promoting mental health literacy and wellbeing among communities, health workers, and other stakeholders. It includes mental health education and training programs that enable people to recognize mental health conditions, understand their causes and treatments, and support others who are experiencing mental health challenges. The component also promotes positive mental health through resilience building, stress management, and coping skills training; social and emotional learning programs; and the promotion of healthy lifestyles, including physical activity, healthy eating, and adequate sleep. It works to create supportive environments that foster mental health and wellbeing, including safe and inclusive communities, supportive workplaces, and nurturing families.

Component 4: Social Determinants and Mental Health

This component addresses the social determinants of mental health through cross-sectoral interventions and policy engagement. It includes interventions to reduce poverty and inequality, improve access to education and employment, address violence and discrimination, and promote social inclusion. The component works with partners from the social protection, education, and justice sectors to address the root causes of mental health conditions. It also supports community-led initiatives that address the social determinants of mental health, including women's empowerment, youth engagement, and the promotion of social cohesion.

Component 5: Evidence Generation and Policy Engagement

This component focuses on generating evidence on mental health and wellbeing and translating that evidence into policy and practice. It includes the production of policy briefs, evidence summaries, and technical reports on mental health; the organization of policy dialogues and stakeholder workshops; and the provision of technical assistance to county and national governments. The component also generates evidence on the effectiveness of mental health interventions, contributing to the global knowledge base. It works to strengthen the capacity of civil society organizations to advocate for mental health policies that protect vulnerable populations.

Target Populations

The program targets vulnerable populations in four counties in Kenya, selected based on the prevalence of mental health conditions and the availability of mental health services. The primary beneficiaries include:

• Adolescents and youth: This group is at high risk for mental health conditions and faces unique challenges related to social, emotional, and cognitive development.
• Women: Women are disproportionately affected by mental health conditions, including depression, anxiety, and post-traumatic stress, and often face barriers to accessing care.
• People living in poverty: Poverty is a key driver of mental health conditions and a barrier to accessing care.
• People affected by violence and conflict: This group is at high risk for post-traumatic stress, depression, and other mental health conditions.
• People with disabilities: This group is often excluded from mental health services and faces discrimination and social exclusion.
• People living with HIV: This group faces a high burden of mental health conditions, including depression, anxiety, and substance use disorders.

Implementation Approach

The program is implemented through a multi-stakeholder, participatory approach that involves communities, county governments, and other partners at all stages. The following principles guide our implementation approach:

• Community Engagement: We work in close collaboration with communities to co-design and co-implement interventions, ensuring that they are relevant, acceptable, and sustainable.
• Integration: The program is integrated with existing health, education, social protection, and other services to maximize efficiency and sustainability.
• Human Rights-Based Approach: The program is grounded in a human rights framework, ensuring that the rights and dignity of people with mental health conditions are respected and protected.
• Evidence-Based: The program is grounded in the best available evidence and is continuously informed by monitoring and evaluation data.
• Systems Thinking: We adopt a systems approach that considers the complex interactions between mental health, social, economic, and environmental systems.
• Equity and Inclusion: The program is designed to address inequalities and reach those who are most vulnerable to mental health conditions and barriers to care.

Partners

The program is implemented in partnership with a range of organizations and institutions that bring complementary expertise and resources.

• County Governments: The program works closely with county health and social protection departments to align with local priorities and systems.
• Community-Based Organizations: Local CBOs are engaged in community mobilization, outreach, and implementation of interventions.
• Mental Health Advocacy Groups: Partnerships with advocacy organizations support stigma reduction and policy engagement.
• Academic Institutions: Partnerships with universities support research, monitoring and evaluation, and capacity strengthening.
• People with Lived Experience: Meaningful engagement of people with lived experience in all aspects of the program, including design, implementation, and evaluation.

Monitoring, Evaluation, and Learning

The program has a robust monitoring, evaluation, and learning (MEL) system that tracks progress toward objectives, assesses effectiveness, and generates evidence for program improvement. Key elements of the MEL system include:

• Baseline and Endline Surveys: Comprehensive household surveys measure changes in mental health outcomes, mental health literacy, stigma, and related indicators.
• Routine Data Collection: Health management information systems (HMIS), program monitoring tools, and mental health registries provide ongoing data on service coverage and quality.
• Qualitative Research: Focus group discussions, in-depth interviews, and participant observation explore experiences, barriers, and enablers related to mental health and wellbeing.
• Stigma Measurement: Validated scales measure stigma and discrimination at the community and institutional levels.
• Dissemination: Findings are disseminated through reports, policy briefs, presentations, and publications.

Expected Outcomes

By the end of the program, we expect to achieve the following outcomes:

• Improved Mental Health Outcomes: The prevalence of depression, anxiety, and other mental health conditions will decline by at least 20% in target areas.
• Reduced Stigma: Stigma and discrimination associated with mental health conditions will decline by at least 30% in target communities.
• Enhanced Mental Health Literacy: At least 80% of target communities will demonstrate improved mental health literacy, including recognition of mental health conditions and knowledge of where to seek help.
• Improved Service Coverage: At least 60% of people with mental health conditions in target areas will have access to quality mental health services.
• Strengthened Mental Health Systems: At least 80% of health facilities in target areas will have the capacity to deliver quality mental health services.
• Influenced Policy: At least three policy documents will incorporate evidence generated by the program.