1 - (SYM 105) the Intersection of Mental Health and Intimate Partner Violence Among Adolescents in Rural Western Kenya: A Qualitative Study

Background

Patterns of intimate partner violence (IPV) often begin during adolescent dating relationships. Mental health challenges like depression and post-traumatic stress symptoms are known drivers and outcomes of IPV victimization and perpetration, but this intersection has not been explored in depth in adolescent dating relationships in sub-Saharan Africa.  

Methods

This study took place in Muhuru Bay, Kenya, a rural fishing community on the coast of Lake Victoria in Western Kenya. Focus groups discussions (FGDs) were conducted with youth aged 9-17 (n=51) and caregivers (n=18) to explore gender role expectations, characteristics of dating relationships, patterns of IPV, drivers of mental health problems among adolescents, and existing sources of support. FGDs were audio recorded, transcribed, and when necessary, translated from Kiswahili or Luo to English. Data were analyzed using applied thematic analysis. 

Results 

Qualitative results highlighted significant mental health challenges among adolescents as well as the early emergence of violence in dating relationships. Common drivers of mental health problems described across FGDs included socioeconomic stressors, substance use, unwanted pregnancies, grief from parental death, and romantic relationship problems. Adolescent and adult participants noted the early onset of dating, beginning as early as 10 years old. Often the relationships occur in secrecy because of disapproval from parents and teachers, leaving survivors of violence with few options for support. Caregivers and youth identified IPV as a common outcome in dating relationships and is often the result of disagreements, financial expectations of a partner, perceived or actual infidelity, or boyfriends attempting to “correct” a girlfriend’s behavior. Though physical and psychological violence were associated with feelings of shame and guilt, violence was also seen as the expected method to resolve conflicts between partners. Both male and female youth reported the most serious consequence of violence in dating relationships can be death--either death by a partner or death by suicide. Peers were identified most often as the primary source of support for both mental health and romantic relationship problems. 

Discussion

The intersection of mental health challenges and the emergence of IPV during adolescence point to opportunities for combined interventions that promote both psychosocial wellbeing and healthy relationship development.