Evaluating changes in recovery in people living with severe and persistent mental illness after psychiatric Rehabilitation Services at Moi Teaching and Referral Hospital, Eldoret, Kenya

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.