Understanding Mental Health Among University Students in Kenya: What Role Do Family Support and Age Play?

Bylhah Mugotitsa^1,2*Joseph Kuria¹David Amadi³Jacob Masai⁴Eric Angula⁴Benjamin Tsofa⁵Jay Greenfield⁶

• ¹African Population and Health Research Center (APHRC), Nairobi, Kenya
• ²Strathmore Business School, Strathmore University, Nairobi, Kenya
• ³London School of Hygiene and Tropical Medicine, University of London, London, London, United Kingdom
• ⁴Medtronics Labs, Kenya, Nairobi, Kenya
• ⁵Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
• ⁶Committee on Data of the International Science Council (CODATA), Paris, France

Objective: Mental health conditions contribute significantly to the global disease burden, yet their determinants and predictors remain underexplored in Kenya. This study examined the prevalence of mental health conditions, and the factors associated with them among university students.A cross-sectional study of 1,424 students at Pwani University, Kenya, assessed anxiety, depression, and psychosis using validated screening tools; the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Psychosis Screening Questionnaire (PSQ). Chi-square tests analyzed associations, while binary logistic regression identified predictors. Confounders were controlled through multivariable adjustments, and model selection was guided by both the clinical relevance and statistical significance of variables.The prevalence of mental health conditions among students was 30.9%. Those from unsupportive families had the highest prevalence at 35.2% (χ² = 94.91, p < 0.001), while firstyear students had the highest rate among academic levels at 40.7% (χ² = 24.38, p < 0.001).Students aged 25-29 years were 2.6 times more likely to experience mental health conditions (OR = 2.6, 95% CI: 1.67-3.98, p < 0.001). Access to mental health services (χ² = 4.62, p = 0.032) and mental health insurance (χ² = 4.11, p = 0.043) were linked to lower odds of mental health conditions, reducing the risk by 34% and 33%, respectively.The findings highlight the urgent need for age-sensitive, student-centered mental health interventions in Kenyan universities. Specifically, universities should implement targeted support programs for first-year and final-year students, who face unique mental health risks due to transitional and graduation-related stressors. Additionally, integrating family engagement initiatives to strengthen family support structures can serve as a protective factor against mental health challenges. Policies expanding access to mental health insurance and services should also be prioritized. Given the use of non-probabilistic sampling, findings should be interpreted with caution. Future research should investigate longitudinal trends to establish causal relationships and inform the development of evidence-based policies.