Apples, Oranges, Vanilla, and Myths: Adolescents’ Discourse on Alcohol and Substance Use in Kenya

Abstract

Abstract Background and Purpose: Alcohol and substance use disorders (ASUD) are highly prevalent among adolescents in sub-Saharan Africa and co-occur with mental health disorders. This study aims to understand the adolescents’ awareness about and attitudes towards ASUD and mental health literacy, with the long-term goal of informing the development of a sustainable intervention. Methods: An exploratory qualitative study included 144 adolescents (aged 15-19) in 12 focus group discussions (FGDs). Participants were purposely sampled from three informal settlements in Nairobi and Kiambu counties in Kenya. Separate FGDs were conducted for boys and girls in two age groups (15-17 and 18-19). FGDs were audio recorded, transcribed, and translated into English when needed and analyzed using deductive thematic content analysis. Results: Adolescents demonstrated both knowledge of facts and “myths” about mental health and ASUD. They believed ASUDs were significant community problems but at the same time perceived options that some substances like shisha (Hookah) as harmless. They also acknowledge that environmental factors, like financial and social pressures, increase the risk of ASUD. Adolescents made the connection that family members’ alcohol and substance use (ASU) and easy accessibility of alcohol and other substances of abuse in the community present a further risk for substance use. Adolescents highlighted that future interventions should include mental health and substance use education (risks and coping strategies), and access to non-stigmatizing support. Conclusions and Implications: Study Results showed that adolescents are aware of ASUD in their communities and identified a combination of community-based support and virtual engagement via mobile technology which they viewed as useful resources possessing the potential for effective ASU prevention and intervention among adolescents.