TY - JOUR PY - 2023// TI - Mental health and gender-based violence: an exploration of depression, PTSD, and anxiety among adolescents in Kenyan informal settlements participating in an empowerment intervention JO - PLoS one A1 - Friedberg, Rina A1 - Baiocchi, Michael A1 - Rosenman, Evan A1 - Amuyunzu-Nyamongo, Mary A1 - Nyairo, Gavin A1 - Sarnquist, Clea SP - e0281800 EP - e0281800 VL - 18 IS - 3 N2 - OBJECTIVE: This study examines the prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) among adolescents attending schools in several informal settlements of Nairobi, Kenya. Primary aims were estimating prevalence of these mental health conditions, understanding their relationship to gender-based violence (GBV), and assessing changes in response to an empowerment intervention.

METHODS: Mental health measures were added to the final data collection point of a two-year randomized controlled trial (RCT) evaluating an empowerment self-defense intervention. Statistical models evaluated how past sexual violence, access to money to pay for a needed hospital visit, alcohol use, and self-efficacy affect both mental health outcomes as well as how the intervention affected female students' mental health.

FINDINGS: Population prevalence of mental health conditions for combined male and female adolescents was estimated as: PTSD 12.2% (95% confidence interval 10.5-15.4), depression 9.2% (95% confidence interval 6.6-10.1) and anxiety 17.6% (95% confidence interval 11.2% - 18.7%). Female students who reported rape before and during the study-period reported significantly higher incidence of all mental health outcomes than the study population. No significant differences in outcomes were found between female students in the intervention and standard-of-care (SOC) groups. Prior rape and low ability to pay for a needed hospital visit were associated with higher prevalence of mental health conditions. The female students whose log-PTSD scores were most lowered by the intervention (effects between -0.23 and -0.07) were characterized by high ability to pay for a hospital visit, low agreement with gender normative statements, larger homes, and lower academic self-efficacy.

CONCLUSION: These data illustrate a need for research and interventions related to (1) mental health conditions among the young urban poor in low-income settings, and (2) sexual violence as a driver of poor mental health, leading to a myriad of negative long-term outcomes.

Language: en

LA - en SN - 1932-6203 UR - http://dx.doi.org/10.1371/journal.pone.0281800 ID - ref1 ER -