Abstract:
Objective: People living with severe and persistent mental illness (SPMI) in Kenya lack access to recovery-
based services. In this study, we assessed changes in recovery in people living with SPMI in Kenya 6 months
after receiving services at the Moi Teaching and Referral Hospital Nawiri Recovery and Skills Centre
(Nawiri). Methods: A retrospective evaluation was conducted using a pretest/posttest design analyzing
Nawiri care program data collected on admission and 6 months after discharge for recovery metrics.
Results: Thirty patients, with an average age of 33 years and of whom 57% are female, met criteria for the
study, with the most common mental diagnoses being schizophrenia (60%) and bipolar mood disorder
(30%); 76% of participants met the definition of extreme poverty and had a median of two psychiatric
admissions in the 12 months before admission. Patients improved significantly on recovery outcomes 6
months after receiving care at Nawiri, including decreased psychiatric hospitalizations (from 1.33 to 0.07),
improved rates of independence in life skills (75.9%–96.7%), improved engagement in income generating
activities (23.3%–63.3%), improved food security (69.0%–96.7%), decreased days of functional
impairment from symptoms (3.7 to 1.7 days in past week), decreased substance use (53.3%–13.8%),
and improved engagement in outpatient mental health care (50.0%–93.3%). Conclusions and Implications
for Practice: People living with SPMI had improved recovery 6 months after receiving residential
psychiatric rehabilitation services in western Kenya. A more robust evaluation of program effectiveness and
implementation is recommended to help explore generalizability and scalability to other resource limited
settings.