In just five months, Nakuru County recorded 802 mental health referral cases at the Nakuru County Referral Hospital, a powerful early indicator of what is possible when community systems, county leadership and aligned partnerships work together. This progress followed the training of 3,459 Community Health Promoters (CHPs) across the county on a technical mental health module, equipping them to identify early signs of mental health conditions, support households, and link clients to appropriate care.
Mental health has long been one of the most under-resourced areas within primary health care. Yet in Nakuru, a quiet but transformative shift is underway. Through a partnership between the County Government of Nakuru, Amref Health Africa and the Johnson & Johnson Foundation, mental health is being repositioned as a frontline health priority, starting at the household level.
Recently, the Johnson & Johnson Foundation’s Executive Leadership team visited Nakuru County to witness firsthand how this partnership is strengthening mental health services at both community and facility levels. From CHPs conducting household visits to healthcare workers delivering quality mental health services at primary facilities and referral hospitals, the visit offered a rare opportunity to see how investment in people, systems and leadership translates into real-world impact.
“You normally don’t often see this level of ambition, targeting all CHPs to be trained,” noted Howard Reid, President, Johnson & Johnson Foundation. “The fact that Nakuru has taken this bold step is setting a new standard for what community mental health systems can achieve.”
At the heart of this work is a shared vision. Nakuru County is committed to integrating mental health into primary health care and strengthening its health workforce. Amref Health Africa brings deep experience in community health systems strengthening and frontline worker capacity building. The Johnson & Johnson Foundation, through its global mental health agenda, is focused on expanding access to services, supporting caregiver wellbeing, and strengthening health systems sustainably. Together, these aligned goals are creating a scalable and sustainable model for mental health integration.
Dr. Meshack Ndirangu of Amref captured the essence of this collaboration simply: ”This locally driven approach has ensured that mental health services are not only technically sound but contextually relevant and owned by the county.”
The impact is already visible. CHPs are identifying cases early at the household level, referring clients for care, and supporting treatment follow-up within the community. Healthcare workers, in turn, are better equipped to assess, manage and support patients with mental health conditions. While most patients continue to be managed at the community and primary facility level, stronger referral pathways now ensure that more complex cases receive specialized care when needed.
Yet, as partners acknowledged during the visit, challenges remain. Strengthening mental health data systems, improving reporting tools, addressing health worker workload, and safeguarding caregiver wellbeing are all critical next steps. But the foundation has been laid.
What Nakuru County is demonstrating is both simple and profound: that sustainable mental health care does not begin in specialized hospitals alone it starts in homes, in communities, with empowered CHPs, supported healthcare workers, visionary county leadership, and committed partners.
As the county continues to strengthen systems, document impact, and expand access, this growing partnership offers a compelling lesson for other counties across Kenya and beyond: when goals are aligned, leadership is strong, and communities are placed at the centre, mental health transformation is not only possible it is inevitable.