Aggrey Gisiora Mokaya

Background Artificial intelligence (AI) is increasingly used for mental health support, through both purpose-built products and general-purpose large language models (LLMs), at a pace far greater than evidence of their efficacy or safety. There is no consensus taxonomy of the potential harms arising from this use, and existing classification frameworks are fragmented across clinical, computational, ethical, and regulatory domains. Objective This scoping review aims to systematically map the harms which may arise from engaging with AI for mental health support, as formulated in the academic literature, regulatory frameworks, grey literature, and practitioner guidance, to inform the co-production of a harm taxonomy. Methods We will follow the framework of Arksey and O’Malley, as refined by Levac et al. and the Joanna Briggs Institute, with reporting adhering to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We will search MEDLINE (Ovid), Embase (Ovid), APA PsycINFO (EBSCOhost), Scopus, Web of Science, ACM Digital Library, IEEE Xplore, ProQuest Dissertations and Theses Global, PROSPERO, and Google Scholar for peer-reviewed literature and preprints, combining terms for AI technologies, mental health, and harm. Grey literature searches will cover regulatory bodies, professional associations, the Mental Health Innovation Network, OpenSyllabus, and preprint repositories. No date restriction will be applied; searches will be restricted to English. Titles, abstracts, and full texts will be screened independently by two reviewers following a calibration exercise. Data will be charted using a piloted standardised instrument and synthesised narratively through descriptive tabulation and iterative harm mapping, with consultation of lived experience advisors and clinical experts before finalisation. Ethics and dissemination No primary data will be collected, so ethical approval is not required. Findings will be published as a peer-reviewed manuscript, presented at conferences, and used to inform co-production workshops within the SAFER-MH programme.

Background: Effective preparedness is essential to safeguard healthcare workers (HCWs) and strengthen outbreak response. The 2022–2023 Ebola virus disease (EVD) outbreak in Uganda exposed critical gaps in healthcare preparedness, with HCWs accounting for 13.4% cases and 12.7% deaths. Aim: The study assessed preparedness of HCWs in public health facilities in Mubende and Kassanda districts, Uganda for EVD containment. Setting: The study was conducted in 16 public health facilities in districts severely affected by the 2022–2023 EVD outbreak. Methods: A cross-sectional study was conducted in May 2024 and June 2024 among 376 HCWs. Preparedness was assessed based on knowledge, infection prevention and control practices (IPC) practices and attitudes towards EVD containment. Data were collected using self-reported structured questionnaires. Preparedness was determined using median split. Logistic regression analysis was performed in STATA, and 95% confidence intervals (CIs) were calculated to assess statistical significance. Results: One hundred and fifteen (30.6%) HCWs met preparedness criteria. A total of 295 HCWs (78.5%) could not correctly don personal protective equipment (PPE), while 258 (68.6%) could not correctly doff PPE. The HCWs with degree or higher had higher odds of being prepared (adjusted odds ratio [aOR]: 4.55, 95% CI: 1.26–16.45) compared to those with lower qualifications. Similarly, HCWs with 11–15 years of experience had higher odds of being prepared compared to those with fewer years (aOR: 3.47, 95% CI: 1.12–10.07). Conclusion: Overall preparedness among HCWs was low. This highlights the need for continuous professional development and routine practical training on PPE use including donning and doffing procedures. Contribution: Findings provide evidence to guide targeted interventions for improving HCW preparedness for future EVD outbreaks.

Background Adolescents and young people (AYP) aged 10–24 years in Africa experience a high burden of mental health disorders but face significant barriers to accessing care, including a severe shortage of mental health professionals, stigma, and limited integration of mental health services into primary healthcare. Digital mental health interventions (DMHIs) offer a promising avenue to bridge these gaps by providing accessible, scalable, and potentially equitable support. However, little is known about the effectiveness, acceptability, and equity impacts of these interventions among African AYP. Objective This systematic review aims to identify, characterize, and synthesize evidence on DMHIs targeting adolescents and young people in Africa, focusing on mental health outcomes, engagement, feasibility, and equity considerations. Methods We will search PubMed, Scopus, Web of Science, and EBSCOhost databases, as well as the PsyberGuide repository, for empirical studies published between January 1, 2015, and April 3, 2025. Eligible studies must evaluate a digital mental health intervention among AYP aged 10–24 years living in Africa. Study designs will include randomized controlled trials, quasi-experimental studies, observational studies, and mixed-methods studies. Outcomes of interest include mental health symptom reduction (depression, anxiety, stress), psychological well-being, engagement, feasibility, acceptability, and equity-related factors such as gender inclusivity and digital access. Risk of bias will be assessed using RoB 2 and ROBINS-I tools, and evidence quality will be rated using the GRADE approach. Quantitative synthesis will be conducted where feasible, otherwise narrative synthesis will be employed. Conclusion This review will provide a comprehensive synthesis of available evidence on DMHIs for adolescents and young people in Africa, offering critical insights into their effectiveness, feasibility, and contribution to promoting mental health equity. The findings aim to inform the development, implementation, and policy integration of digital mental health strategies tailored to young populations in diverse African contexts.

Depression is common among adolescents more so during the transition to secondary school, and the psychosocial and emotional changes that accompany adolescence. This study sought to assess the prevalence and predictors of depression among students joining public secondary schools in Nairobi County. The study was carried out at five selected public secondary schools in Nairobi County covering 539 students between the ages of 11 and 18 years. The Patient Health Questionnaire‐Adolescent version (PHQ‐A) was used to collect data on depression. For suicidal behavior, the Suicide Behavior Questionnaire‐revised version was used. The Adolescent Peer Relations Instrument was used to assess bullying victimization. These were augmented by a sociodemographic questionnaire. Depression prevalence rates were generated using a generalized linear model customized with a log link and a Poisson distribution for a common binary outcome. The prevalence of depression was found to be 14.5%, with a mean PHQ‐A score of 6.16 (SD = 3.16). Predictors of depression were suicide risk (adjusted prevalence ratio [aPR] = 3.07, confidence interval, CI [1.94–4.88]; p < .001) and lifetime alcohol use (aPR = 2.24, CI [1.36–3.68]; p = .001). Depression is prevalent among adolescents joining secondary schools in Nairobi County. Counselor‐led school‐based cognitive behavioral therapy could be a sustainable strategy for reducing depression symptoms and guiding preventive efforts among adolescents in this context.

Stigma and insufficient training contribute significantly to the substance use disorder pandemic. This 2014 study assessed the impact in Kenya of online competency-based courses on peer and mentor ...

This study describes reported substance use among Kenyan healthcare workers (HCWs), as it has implications for HCWs’ health, productivity, and their ability and likelihood to intervene on substance use. The Alcohol Smoking and Substance Involvement Screening Test (ASSIST) was administered to a convenience sample of HCWs (n = 206) in 15 health facilities. Reported lifetime use was 35.8% for alcohol, 23.5% for tobacco, 9.3% for cannabis, 9.3% for sedatives, 8.8% for cocaine, 6.4% for amphetamine-like stimulants, 5.4% for hallucinogens, 3.4% for inhalants, and 3.9% for opioids. Tobacco and alcohol were also the two most commonly used substances in the previous three months. Male gender and other substance use were key predictors of both lifetime and previous three months’ use rates. HCWs’ substance use rates appear generally higher than those seen in the general population in Kenya, though lower than those reported among many HCWs globally. This pattern of use has implications for both HCWs and their clients.

Purpose The aim of this study was to estimate the prevalence and correlates of mental disorders among upper primary school children in grades five through seven in Kenya. Methods The Youth Self Report (YSR) instrument was adapted for use in Kenyan schools and administered to 2267 school children in grades five through seven from 23 randomly selected schools. We estimated the prevalence of DSM-IV mental disorders, and used logistic regression analyses to examine the socio-demographic factors associated with each disorder. Results The prevalence of any mental disorder among Kenyan school children was 37.7 % (95 % CI = 35.7–39.7 %). Somatic complaints were the most prevalent (29.6 %, 95 % CI = 27.8–31.5 %), followed by affective disorders (14.1 %, 95 % CI = 12.7–15.6 %) and conduct disorder (12.5 %, 95 % CI = 11.2–13.9). The presence of one or more comorbid mental disorder was seen among 18.2 % (95 % CI = 16.6–19.8 %) of children. Male sex, living in a peri-urban vs. rural area, being held back in school, having divorced or separated parents, and having an employed mother were associated with an increased likelihood of having most of the mental disorders examined, whereas increasing age was associated with a reduced likelihood. Conclusions We observed a high prevalence of mental disorders among school children in Kenya. If not detected early, these disorders may interfere with children’s psychological, social, and educational development. Our findings highlight the importance of implementing screening measures in schools that can detect single and multiple disorders in order to improve the mental health and well-being of the next generation.