Skip to main content

Table 1 Frequencies within challenge domains and related sub-themes

From: Mental health treatment in Kenya: task-sharing challenges and opportunities among informal health providers

  Definition Frequency
Screening intake
 1. Mistrust of informal health providers Patients tend to have negative biases towards healers 40
  1.1 Belief system Patients’ belief systems are in opposition to those of healers 14
  1.2 Secondary gain Patients assume that healers make some form of material gain 7
  1.3 Mental health credentials Patients believe healers lack the necessary credentials 11
  1.4 Suggestions Informal Health Providers (IHPs) made suggestions as to how to break these biases 10
 2. Cultural misunderstanding and stigma of mental health General misunderstandings and often negative associations about mental health 37
  2.1 Lack of knowledge No knowledge about mental health 12
  2.2 Stigma around mental disorders Negative beliefs about mental illness 7
  2.3 Social support Partly because of stigma, families and friends do not support the mentally ill 16
  2.4 Fear of treatment Fears about the hospital testing and procedures for mental disorders 5
  2.5 Suggestions IHPs provided opportunities that can be used to reduce these negative perceptions 12
Between screening and treatment
 3. Resource barriers Lack necessary resources (financial, time, etc.) to travel to hospital for treatment 61
  3.1 Patient resources Patients lack funds to pay for public transport to the hospital, or for food (requiring work at time of appointment) 38
  3.2 IHP resource barriers IHPs lack resources for themselves and for supporting their patients 33
  3.3 Suggestions IHPs suggest ways of dealing with the above barriers 10
 4. Resistance to treatment Patients resist treatment in multiple ways (e.g. illness denial, refusal to go to hospital, substance addiction) 25
  4.1 Suggestions IHPs identify ways of strengthening the willingness of patient referral for those suffering from mental illnesses 11
 5. Limitations of the referral system Lack of recognition on the limit of IHPs’ role in the task-sharing model, resulting in responsibilities outside their role as referrers 25
  5.1 Suggestions IHPs emphasized the need for specialized training such as counselling to know how to motivate patients who have lost hope, to seek further treatment without being accompanied by IHPs 5
During treatment
 6. Treatment infrastructure issues Many logistical challenges are faced upon arrival to the hospital 39
  6.1 Procedural issues Some untrained hospital staff often do not recognize referral forms 24
  6.2 Drug availability Drugs are often unavailable at the hospital and patients are forced to purchase elsewhere 9
  6.3 Limited medical staff There are often limited medical staff and long queues at the health facilities 6
  6.4 Suggestions IHPs suggested how to improve infrastructure issues 5