Sub-Saharan Africa has fewer than 2 mental health workers per 100,000 people. To bridge this gap, researchers developed Shamiri, a group intervention delivered by young, locally-recruited lay providers rather than trained therapists. This study examined whether this approach could effectively treat adolescent depression and anxiety.
694 Kenyan secondary school students with depression or anxiety symptoms were randomly assigned to receive either Shamiri (focusing on growth mindset, gratitude, and values) or a study skills program, both delivered in 4 weekly group sessions by trained lay providers. Depression and anxiety symptoms were measured before treatment, immediately after, and at 2-week follow-up.
Both groups showed symptom improvements, but Shamiri was more effective. At follow-up, 80% of Shamiri participants showed clinically meaningful improvement in depression compared to 66% in the control group. For anxiety, 82% of Shamiri participants improved versus 72% of controls. Effects were maintained two weeks after treatment ended.
Lay providers can effectively deliver mental health interventions to adolescents in low-resource settings. The Shamiri model offers a scalable approach to addressing the mental health treatment gap in Africa, demonstrating that brief interventions focused on character strengths can produce clinically significant improvements without requiring specialized mental health training.
