We are currently in the midst of a global crisis in child and adolescent mental health. The COVID-19 pandemic put a spotlight on the significant barriers youth and their families experience to accessing quality, evidence-based mental health care in all settings, including those that are otherwise considered to be resource-rich. In Kenya, the 2021 National Adolescent Mental Health Survey found that 12.2 percent of Kenyan adolescents (10-17 years) met criteria for a psychiatric disorder. However, of those, only 11.1 percent had accessed any form of support for their mental health concerns in the prior year, in part because of a lack of available services.
Mental health plays a critical role in the development and overall well-being of young people, which is why efforts are being undertaken at the MTRH-Rafiki Center for Excellence in Adolescent Health to improve the availability of mental health services for youth in western Kenya.
Florence Jaguga, MBChB, MMed, and Brittany McCoy, MD, are working together to lead progress towards the mental health-related care, research, and education priorities set out by the AMPATH Adolescent Working Group at the AMPATH Adolescent Summit earlier this year.
Brittany McCoy, MD
Dr. McCoy is the new Adolescent Mental Health Team Lead for AMPATH, a T32 Postdoctoral Research Fellow in Psychiatry, and an Instructor in the Departments of Psychiatry, and Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai. She is a recent graduate of the Mount Sinai Triple Board Residency Program, where she trained in general pediatrics, general psychiatry, and child and adolescent psychiatry, and completed the requirements of both the pediatrics global health and global mental health residency tracks.
Dr. McCoy has a long history of engagement with AMPATH Kenya, starting in 2016 when she served for a year as the Indiana University School of Medicine Pediatric Global Health Research Scholar working with Rachel Vreeman, MD, MS. She has completed AMPATH clinical rotations at MTRH and continued to work with Dr. Vreeman and her team on research projects related to the mental health of youth living with HIV throughout her subsequent medical education and residency training.
More recently, she completed a study funded by an Pediatric Research Scholars Award at Icahn Mount Sinai to adapt a battery of mental health measures culturally and developmentally for Kenyan youth living with HIV. In her new position at AMPATH, Dr. McCoy hopes to use the unique skillset she has gained as a “Triple Boarder” to inform research, care, and education initiatives aimed at increasing adolescents’ access to evidence-based, culturally and developmentally appropriate mental health services in western Kenya.
Dr. Jaguga is a psychiatrist at MTRH and Head of the Alcohol and Drug Abuse Rehabilitation Services. She is co-chair of the AMPATH Adolescent Health Working Group. Dr. Jaguga has conducted research projects to evaluate the feasibility of a peer-led substance use screening and brief intervention program for youth at Rafiki. Her research findings support the feasibility of this program.
Florence Jaguga, MBChB, MMed
Dr. Jaguga has worked to integrate mental health and substance use screening for youth into the AMPATH electronic medical records system. The tools included in the screening are the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) scale, and the Substance Use Screening to Brief Intervention (S2BI) tool.
Next steps include training peer counselors to conduct screening for mental health using the tools. Youth screening positive will be referred to the psychologist that is currently stationed at Rafiki Clinic. Rafiki now also runs a weekly mental health clinic led by an MTRH psychiatrist, and youths who screen positive for a mental health concern will also be referred to this weekly clinic.
Over the coming months, Dr. Jaguga and Dr. McCoy will work together with others in the adolescent health and mental health initiatives at AMPATH to continue to grow the mental health services offered by the Rafiki Center and support adolescents’ mental health.