title: Nurses' perceptions of mental healthcare in primary-care settings in Kenya.
abstract: Kenya maintains an extraordinary treatment gap for mental health services because the need for and availability of mental health services are extraordinarily misaligned. One way to narrow the treatment gap is task-sharing, where specialists rationally distribute tasks across the health system, with many responsibilities falling upon frontline health workers, including nurses. Yet, little is known about how nurses perceive task-sharing mental health services. This article investigates nurses' perceptions of mental healthcare delivery within primary-care settings in Kenya. We conducted a cross-sectional study of 60 nurses from a public urban (n = 20), private urban (n = 20), and public rural (n = 20) hospitals. Nurses participated in a one-hour interview about their perceptions of mental healthcare delivery. Nurses viewed mental health services as a priority and believed integrating it into a basic package of primary care would protect it from competing health priorities, financial barriers, stigma, and social problems. Many nurses believed that integrating mental healthcare into primary care was acceptable and feasible, but low levels of knowledge of healthcare providers, especially in rural areas, and few specialists, would be barriers. These data underscore the need for task-sharing mental health services into existing primary healthcare in Kenya.
authors.affiliation: a Science, Technology, and International Affairs , Walsh School of Foreign Service, Georgetown University , Washington DC , USA.
authors.forename: Emily
authors.identifier: 0000-0002-5826-1321
authors.initials: E
authors.lastname: Mendenhall
authors.affiliation: b Africa Mental Health Foundation , Nairobi , Kenya.
authors.forename: Gitonga
authors.initials: G
authors.lastname: Isaiah
authors.affiliation: a Science, Technology, and International Affairs , Walsh School of Foreign Service, Georgetown University , Washington DC , USA.|b Africa Mental Health Foundation , Nairobi , Kenya.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Nelson
authors.affiliation: b Africa Mental Health Foundation , Nairobi , Kenya.
authors.forename: Abednego
authors.initials: A
authors.lastname: Musau
authors.affiliation: a Science, Technology, and International Affairs , Walsh School of Foreign Service, Georgetown University , Washington DC , USA.|c Department of Global Health and Development , London School of Hygiene and Tropical Medicine , London , UK.
authors.forename: Adam D
authors.initials: AD
authors.lastname: Koon
authors.affiliation: d African Studies , Walsh School of Foreign Service, Georgetown University , Washington DC , USA.
authors.forename: Lahra
authors.initials: L
authors.lastname: Smith
authors.affiliation: b Africa Mental Health Foundation , Nairobi , Kenya.
authors.forename: Victoria
authors.initials: V
authors.lastname: Mutiso
authors.affiliation: b Africa Mental Health Foundation , Nairobi , Kenya.|e Department of Psychiatry , University of Nairobi , Nairobi , Kenya.
authors.forename: David
authors.initials: D
authors.lastname: Ndetei
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006780:Hospitals, Rural; D006786:Hospitals, Urban; D006801:Humans; D007630:Kenya; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D011320:Primary Health Care; D017149:Private Sector; D017150:Public Sector; D036301:Qualitative Research
keywords: Kenya; Nurses; mental health; task-sharing