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

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. Impact and Implications Residential psychiatric rehabilitation programs after an inpatient stay are a viable addition to the mental health system in resource-limited settings, particularly for patients requiring frequent inpatient care and needing additional skills support to recover successfully in the community.