Every morning, across Kenya, radio stations offer what millions of listeners perceive as professional psychotherapy. These morning zoo-types of shows combine comedy skits and public call-ins, with occasional fake callers, in advising individuals on broken relationships and a host of other personal, emotional and social problems. As a psychologist, I wondered about the growing pervasiveness of this practice. Why do Kenyans turn to the radio with their problems? I decided to conduct a study to explore the roots of help-seeking behaviour.

While in the foundational stages of the study, in 2019, I was attached to the counselling centre of a leading Kenyan university. In my interactions with students, faculty, and staff, students were described as facing plenty of interpersonal, emotional and psychological problems. Despite this, the traffic at the counselling centre was minimal, save for a few walk-in clients and referrals from lecturers and the clinic. Where were students seeking help from?

Turning to literature, I found a study conducted by Chilale et al. in Malawi, which observed a reluctance to seek professional help among people with serious mental health problems. It would appear that this phenomenon is not unique to us. The study, published in 2017, described a preference for the services of traditional faith healers.

I asked myself if the students at the university could be seeking help from traditional faith healers, like the people Chilale and colleagues studied. However, unlike the rural and mostly uneducated people who comprised their sample, to whom access and cost of mental health services was an issue, our university students were urban-dwelling and well-educated. The university provided free counselling services to its students, hence they did not have to spend on therapy. If not seeking out help from radio hosts or traditional faith healers, where were these students turning to with their problems? What barred them from seeking professional therapy from the counselling centre?

I designed a study to explore help-seeking for mental health problems among university students. Drawing my sample from two leading universities in Kenya, I collected qualitative data using focus group discussions. During the interactive sessions, I asked them the hard questions: Where would you go if you have a mental health problem? Why? Why would you not go to the counselling centre?

To set the stage for the discussions, I narrated a short story about an individual suffering from a mental health problem. I asked them to describe what they thought was happening with this individual and what they would do in a similar position. Students who identified the character as having a mental disorder automatically suggested going for therapy. Almost half of the students did not realise that it was a mental health problem, and even after illustrating it to them, they emphasised other solutions, including going to church.

I have chaired conversations at the Kenya Psychology Network (KPN) for years, and one recurrent topic of discussion has been the public perception of therapists fueled by the portrayal of ‘shrinks’ in contemporary media. If you watch any Western TV show or film, therapists are, more often than not, rude and unhelpful to clients. They focus on their own issues in the sessions, talk over their clients, reveal their clients’ problems to third parties, and play mind games. They barely assist clients in resolving personal, emotional and social problems.

In our focus group discussions, students expressed apprehension that therapy would not be helpful to them. Some barely understood what it was and indicated they were unlikely to attend a process they did not understand in its entirety, and whose functionality to their situation was equally unclear. Some expressed apprehension over the ability of therapists to guarantee privacy and confidentiality. “If I become an influential figure, what is the possibility that my therapy notes will not be leaked to the media?” one student asked. While some were familiar with therapy and the therapy process, they were unaware that a counselling centre existed at their universities. I remember a student saying to me, “I have been at this university for four years, but I have never heard of a counselling centre.”

Some students would shy away from professional help-seeking for fear that people would find out, first, that they have a mental health problem, and second, that they are seeking help for it. “What would happen if people were to find out?” I had asked. “They might treat me differently,” they responded. As a result, there was a preference for managing problems by oneself, in other words, suffering in silence. Most students, however, indicated that they would turn to family and close friends for advice if they felt something was wrong. “Would you go for therapy if they suggested it?” I had wanted to know. They said yes.

Family and friends play a vital role in help-seeking. Chilale et al. observed that when an individual had a serious mental health problem, their treatment options depended on their family. If family members believed that the issue was spiritual in nature, then the help sought was from traditional faith healers.

I had set out to explore help-seeking, initially among the Kenyan general population who call into radio stations but later shifted focus to the university students, who amidst a plethora of reported problems, rarely use counselling services provided to them for free by universities. While I identified lack of knowledge, attitude, and stigma as major barriers to professional help-seeking, I did not realise that the issue is more complex and interconnected. People are unlikely to seek counselling if they do not recognise that the problem they are facing is a mental health one. If you do not know that your university has a counselling centre or where the centre is located, how would you know to go there? The public perception of therapists does not help cause in instilling confidence in the use of existing services.

Unravelling these barriers is equally complex. While it might appear that the onus is on university counselling centres, ergo on psychologists, counsellors, and therapists to enhance their visibility, we need to realise that help-seeking might be a collective process. Students are looking to their families and friends for recommendations on where to go to with their problems. If students’ families are unable to identify what they are facing as a mental health problem, they are unlikely to support them in seeking the appropriate help.

Back to the radio shows, I wonder how many people call in because they do not realise that their problems are psychological or mental health related. I wonder how many people call in either because they do not know where else to go, or because they have been led by these shows to believe that you call in to radio for help.

Time for another study.

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