Mental health has an impact on many aspects of our daily lives, more so for adolescents and young women. Globally, about 20 per cent of adolescents and young people experience mental health problems.
In Kenya, one out of four people who seek healthcare has a mental health condition. As Kenya cut the chase to achieve the Sustainable Development Goals 2030 agenda, truth is, it cannot be fully achieved unless mental health is addressed.
One of the major hindrances to the development of quality mental health services is that we are among the 28 per cent of WHO member countries that do not have a separate budget for mental health.
The state of mind in which an adolescent and young person makes an informed choice determines the success of a particular intervention in sexual and reproductive health. Adolescents and young women who have no power to make a choice over their reproductive life, including rape, negotiating for safe sex, intimate partner violence and coercive control could face other consequences apart from mental health.
If pregnancies were not unwanted, fact is, abortions would not take place. There are myths surrounding the mental health of women who procure safe and legal abortion. For instance, anti-abortion researchers have persisted in trying to prove abortion's harmful mental health effects; that if a woman procures an abortion, it threatens her fertility; that they become suicidal or risk breast cancer. None of this is true.
Instead, about 20-40 per cent of women in developing countries experience mental health issues such as depression during pregnancy or after childbirth. Induced abortion is not associated with an increase in breast cancer risk or fertility. Safe and legal abortion of an unwanted pregnancy does not pose a psychological hazard. Psychological research shows that women who had an abortion following an unintended pregnancy are not at any higher risk of subsequent mental health problems than are women whose unintended pregnancy is carried to term. Further, adolescents and young women who are denied abortions are more likely to experience higher levels of anxiety, lower life satisfaction and lower self-esteem compared with those who are able to obtain abortions.
Adolescent girls and young women are at an increased risk of mental health and psycho-social issues as a result of societal and gendered norms. For instance, in many communities, conversations around sex and abortion are taboo, therefore, adolescents and young women have no access to accurate information or parental support prior to sexual debut that would help to prevent unintended pregnancies and process the internalised shame after an abortion.
Hence, the circumstance of secrecy and stigma may pose barriers to disclosing an unintended pregnancy, or experimentation with abortion, to a parent. This barrier extends to the healthcare workers when it comes to follow-up to check how adolescent girls and young women are coping psychologically after an abortion.
Adolescent girls and young women’s SRHR have been largely overlooked in mental health research globally. There is need for attention to issues such as sexual violence and trafficking, female genital mutilation, girl-child marriage and access to safe abortion.
To ensure that mental health remains a key determinant of overall health and wellbeing, the government should take measures to implement the Kenya Mental Health Policy 2015-2030 in order to achieve optimal health status and capacity of each individual.