Mental Health and Substance Use Challenges among Emerging Adults in Coastal Kenya

Abstract

Globally, emerging adults (EAs) aged 18–29 face a disproportionate burden of substance use and mental health challenges, with particularly acute impacts in sub-Saharan Africa. In Kenya’s coastal region, high rates of cannabis, khat, alcohol, cigarettes, and heroin use among EAs intersect with limited mental health awareness, stigma, and restricted access to care. This developmental stage—characterised by identity formation, educational transitions, and economic instability—heightens vulnerability to mental disorders and maladaptive coping. This qualitative study examined mental health challenges, psychological problems, and maladaptive coping mechanisms among EAs with substance use disorders (SUDs) in coastal Kenya. Nine focus group discussions (FGDs) were conducted with 88 participants recruited from treatment facilities across Mombasa, Kilifi, and Kwale counties. Data were collected using a semi-structured guide, transcribed, translated, and thematically analysed using NVivo 11. Findings revealed significant mental health challenges, mainly depression and anxiety; key psychosocial problems, including poor educational and occupational outcomes, dysfunctional relationships, and maladaptive coping strategies. These interconnected issues hurt treatment outcomes for this population. A key limitation of the study is the exclusion of non-treatment-seeking individuals, which may limit generalizability. Stakeholders should prioritise the integration of WHO’s PM+/PM+A and evidence-based CBT approaches to expand culturally responsive, community-based mental health care. While the study focused on treatment-seeking individuals, future research should include non-treatment-seeking EAs and explore gendered experiences to inform inclusive interventions.