Health workers’ perspectives on mental health services in primary health care: Qualitative interviews with stakeholders of the Kenya Mental Health Action Plan 2021–2025

Background: In response to the high burden of mental disorders and limited availability of mental health services, the Kenya Mental Health Policy 2015–2030 introduced a framework to strengthen mental health care. To implement this policy, the Kenya Mental Health Action Plan 2021–2025 operationalizes strategies to integrate mental health care into primary health care (PHC). This study explores how PHC workers in two Nairobi sub counties experience the integration of mental health care as stated in the Action Plan.
Methods: This qualitative phenomenological study employed semi-structured interviews with 14 PHC workers, including nurses, clinical officers, community health promoters, and one community health officer from public and private facilities. A structuring content analysis using a deductive category system was applied.
Results: Mental health care remains inconsistently integrated into PHC. Detection of mental disorders is largely informal with limited use of standardized tools and no possibility for in-service mental health training. Referral pathways are fragmented and often inaccessible due to financial barriers. Essential psychotropic medications are frequently unavailable or unaffordable. Stigma among communities and providers persists as barrier. Most participants were unaware of the Action Plan, indicating poor dissemination.
Conclusion: This study is the first to examine the implementation of the Kenya Mental Health Action Plan 2021–2025 from the perspective of PHC workers. Findings highlight systemic gaps in training, diagnostics, referrals, resources, and stigma reduction which hinder integration. Addressing these challenges requires multilevel strategies, including consistent training, provision of diagnostic tools, accessible referral systems, anti-stigma interventions, and reliable medication supply.