Background
In his speech on Madaraka Day 2019, then president Uhuru Kenyatta addressed the drastic surge of mental distress in Kenyan society. A year later, the newly formed Taskforce on Mental Health in Kenya published a report in which they declared "mental illness a national emergency of epidemic proportions”. In 2021, the Ministry of Health launched a Mental Health Action Plan to concretize and operationalize already existing mental health policies. Nevertheless, governmental expenses remained at a continuous low mark, accounting for only 0,01% of the overall health budget in 2025.
In addition, the Kenyan approach to mental health care is anchored in the Global Mental Health initiative launched by the World Health Organization (WHO) and the World Bank in 2007 to scale up mental health care services especially in the Global South. However, this specific conception, treatability and preventability of mental health is rather narrowly defined and their treatment approaches are mostly based on pharmaceuticals (anti-depressants and anti-psychotics) and psychological interventions (Cognitive behavioral therapy).
Objectives
Given the context of high prevalence of mental distress, limited state funding, and narrow conceptions of mental health, this PhD project seeks to explore how people with mental distress and people providing mental health actually navigate these concrete circumstances in Mombasa. Given the city's importance as a major crossroads for different socio-cultural practices as well as pharmaceuticals and drugs, this project seeks to understand what (therapeutic) practices of care emerge, become neglected or marginalized when state institutions do not provide adequate health care facilities and infrastructures. By giving specific ethnographic focus on the everyday practices of civil-society initiatives and people in mental distress including their multifaceted kin, this project seeks to elaborate on more complex and unstable conceptions of mental distress and mental health care.
Theoretical and methodological approach
This project takes local idioms and conceptions of mental distress and the specific forms of care they necessitate as its ethnographic starting point. Thus, as a general ethnographic positioning, I take Yarimar Bonilla's approach to take research partners' reflections and considerations about mental health as theoretically, conceptually and analytically significant. More concretely speaking, a digital ethnographic approach allows me to explore current discourses on mental health and specifically investigate how young adults converse about and envision distress. In addition, through sensitive ethnography attuned to the intimate and everyday practices I want to attend how care is socially arranged and provided in households, day-care centers and faith groups.
