Pilot study: Evaluation of the referral pathway to Problem Management Plus (PM+) in Nakuru County, Kenya: GBV survivors’ and stakeholders’ statement: A tale of PM+

Introduction Gender-based violence (GBV) is a widespread human rights issue with significant mental health consequences. Organizations such as MIDRIFT-HURINET and the Danish Institution Against Torture (DIGNITY) implemented a structured referral pathway to support survivors, incorporating two mental health and psychosocial support (MHPSS) interventions: Psychological First Aid (PFA) and Problem Management Plus (PM+) in Nakuru County, Kenya. This study examines stakeholder perspectives on the referral system, focusing on its functionality and impact on GBV survivors. Methodology A qualitative research design involving in-depth interviews with survivors and focus group discussions with community health volunteers and professionals was used. Thematic analysis was conducted via NVIVO14 software. Ethical guidelines were strictly followed to ensure participants' safety, privacy, and compliance with Kenyan law. Results Cultural norms significantly impact engagement with mental health programs such as PM+, particularly for men, who often avoid seeking support due to societal expectations of stoicism. Stigma, especially among older adults, further discourages participation. Effective engagement in mental health programs requires culturally relevant strategies, such as involving community leaders and using context-specific messaging. Harmful practices and economic dependencies hinder reporting and accessing services, although awareness is gradually improving. Financial constraints and socioeconomic barriers limit access to mental health services, emphasizing the need for expanded community and government support. Conclusion The referral pathway between PFA and PM+ is widely recognized for its effectiveness, demonstrating strong collaboration between state and nonstate actors. However, challenges such as access barriers, financial constraints, and limited awareness continue to impact its functionality. Despite these obstacles, the system has been instrumental in empowering GBV survivors in Nakuru County. Strengthening community-based mental health services and enhancing collaboration between health providers could further expand and improve mental health care delivery in similar contexts.