Challenges encountered by emerging mental health researchers in sub-Saharan Africa

Abstract

Mental health research in sub-Saharan Africa faces numerous barriers, even as the region experiences an increasing burden of mental health conditions, driven in part by the HIV epidemic, adolescent pregnancy, and the COVID-19 pandemic. Mental illness remains a leading cause of disability, yet access to evidence-based interventions is limited, contributing to a persistent treatment gap. Integrating mental health services into general healthcare settings and expanding telepsychiatry are promising but underutilized strategies. Strengthening research efforts is essential to understanding and addressing the region’s unique challenges. Key barriers include limited funding, poor economic conditions, inadequate research infrastructure, a shortage of skilled researchers, and insufficient mentorship. Socio-cultural factors, such as mental health stigma and conflicting traditional beliefs, further constrain research capacity. Addressing these issues requires enhancing funding, establishing sustainable financing models, investing in infrastructure, implementing capacity-building initiatives, and fostering international collaboration and advocacy. Equitable North-South partnerships and structured mentorship programs are vital for skills transfer and the development of context-specific approaches. Advocacy for supportive policy environments can help mobilize resources for both research and clinical services. Bridging biomedical science with socio-cultural understanding can yield culturally appropriate, community-based interventions. This article highlights the urgency of overcoming financial, structural, and socio-cultural barriers to strengthen mental health research in sub-Saharan Africa. Implementing these strategies can support the development of a robust evidence base, improve service delivery, and promote equitable and sustainable mental health systems - ultimately enhancing the quality of life and socioeconomic participation for millions affected by mental illness in the region.

Keywords

Mental health research / Early-career researchers / Sub-Saharan Africa / Research capacity building

Funding

None.

Conflict of interest

The authors declare they have no competing interests.

References

[1] Addo, R., Agyemang, S.A., Tozan, Y., & Nonvignon, J. (2018). Economic burden of caregiving for persons with severe mental illness in sub-Saharan Africa: A systematic review. PLoS One, 13(8):e0199830. https://doi.org/10.1371/journal.pone.0199830

[2] Akpan, U., Olojo, M., Oni, T., James, E., & Abigail, O. (2024). Assessment of the prevalence and factors contributing to drug and alcohol use among young people in South-South, Nigeria. International Journal of Science and Healthcare Research, 9. https://doi.org/10.52403/ijshr.20240245

[3] Akpan, U.U., & Ja’afar, I.K. (2025). Mental health literacy among young people in Africa: A keystone for social development. Global Health Economics and Sustainability, 025110021. https://doi.org/10.36922/GHES025110021

[4] Akpan, U.U., Ja’afar, I.K., & Eke, S. (2025). The role of education in empowering young people to cope with climate change-induced mental health challenges in developing countries. Global Health Economics and Sustainability, 025110020. https://doi.org/10.36922/GHES025110020

[5] Akpan, U.U., Ja’Afar, I.K., & Eke, S.C. (2025). Addressing the psychological impact of climate-induced disasters on young people in Africa: Challenges and pathways forward. Cambridge Prisms: Global Mental Health, 12:e50. https://doi.org/10.1017/gmh.2024.77

[6] Barke, A., Nyarko, S., & Klecha, D. (2011). The stigma of mental illness in Southern Ghana: Attitudes of the urban population and patients’ views. Social Psychiatry and Psychiatric Epidemiology, 46(11):1191-1202. https://doi.org/10.1007/s00127-010-0290-3

[7] Carod-Artal, F.J. (2017). Social determinants of mental health. In: Bährer-Kohler, S., & Carod-Artal, F.J. (Eds.), Global Mental Health: Prevention and Promotion. Germany: Springer International Publishing, p. 33-46 https://doi.org/10.1007/978-3-319-59123-0_4

[8] Charlson, F.J., Diminic, S., Lund, C., Degenhardt, L., & Whiteford, H.A. (2014). Mental and substance use disorders in Sub-Saharan Africa: Predictions of epidemiological changes and mental health workforce requirements for the next 40 years. PLoS One, 9(10):e110208. https://doi.org/10.1371/journal.pone.0110208

[9] Chibanda, D., Abas, M., Musesengwa, R., Merritt, C., Sorsdahl, K., Mangezi, W., et al. (2020). Mental health research capacity building in sub-Saharan Africa: The African mental health research initiative. Global Mental Health, 7:e8. https://doi.org/10.1017/gmh.2019.32

[10] Chidarikire, S., Cross, M., Skinner, I., & Cleary, M. (2018). Treatments for people living with schizophrenia in Sub- Saharan Africa: An adapted realist review. International Nursing Review, 65(1):78-92. https://doi.org/10.1111/inr.12391

[11] Crabb, J., Stewart, R.C., Kokota, D., Masson, N., Chabunya, S., & Krishnadas, R. (2012). Attitudes towards mental illness in Malawi: A cross-sectional survey. BMC Public Health, 12(1):541. https://doi.org/10.1186/1471-2458-12-541

[12] Deshpande, S.N., Nimgaonkar, V.L., Bhatia, T., Mishra, N.N., Nagpal, R., & Parker, L.S. (2020). Ethical practices and legal challenges in mental health research. Asian Bioethics Review, 12(2):87-102. https://doi.org/10.1007/s41649-020-00116-4

[13] Eboreime, E., Ezeokoli, A., Adams, K., & Banke-Thomas, A. (2022). Prioritizing the mental health needs of pregnant adolescents in sub-Saharan Africa. Journal of Global Health Neurology and Psychiatry, 2022:e2022006. https://doi.org/10.52872/001c.34646

[14] Embleton, L., Logie, C.H., Ngure, K., Nelson, L., Kimbo, L., Ayuku, D., et al. (2023). Intersectional stigma and implementation of HIV prevention and treatment services for adolescents living with and at risk for HIV: Opportunities for improvement in the HIV continuum in Sub-Saharan Africa. AIDS and Behavior, 27(1):162-184. https://doi.org/10.1007/s10461-022-03793-4

[15] Erku, D., Khatri, R., Endalamaw, A., Wolka, E., Nigatu, F., Zewdie, A., et al. (2023). Community engagement initiatives in primary health care to achieve universal health coverage: A realist synthesis of scoping review. PLoS One, 18(5):e0285222. https://doi.org/10.1371/journal.pone.0285222

[16] Frissa, S., & Dessalegn, B.S. (2020). The mental health impact of the COVID-19 pandemic: Implications for sub-Saharan Africa. Psychology Research and Behavior Management. 13:713-720. https://doi.org/10.31219/osf.io/yq9kn

[17] Galvin, M., Chiwaye, L., & Moolla, A. (2023). Perceptions of causes and treatment of mental illness among traditional health practitioners in Johannesburg, South Africa. South African Journal of Psychology, 53(3):403-415. https://doi.org/10.1177/00812463231186264

[18] Gaynor-Brook, L., & PLoS, Medicine Editors. (2023). Towards mental health as a human right: The key role of lived experience. PLoS Medicine, 20(10):e1004307. https://doi.org/10.1371/journal.pmed.1004307

[19] Gilkinson, C., Kinney, M., Olaniyan, T., Murtala, B., Sipilon, M., Malunga, A., et al. (2022). Perceptions about mental healthcare for people with epilepsy in Africa. Epilepsy and Behavior, 127:108504. https://doi.org/10.1016/j.yebeh.2021.108504

[20] Hopkins, I., Verlander, M., Clarkson, L., & Jacobsen, P. (2024). What do we know about sharing power in co-production in mental health research? A systematic review and thematic synthesis. Health Expectations, 27(5):e70014. https://doi.org/10.1111/hex.70014

[21] Jaguga, F., & Kwobah, E. (2020). Mental health response to the COVID-19 pandemic in Kenya: A review. International Journal of Mental Health Systems, 14(1):68. https://doi.org/10.1186/s13033-020-00400-8

[22] Kumar, D.V. (2024). Problems, issues and concerns in mental health. Studies in Psychological Science, 2(1):1.

[23] Langhaug, L.F., Jack, H., Hanlon, C., Holzer, S., Sorsdahl, K., Mutedzi, B., et al. (2020). “We need more big trees as well as the grass roots”: Going beyond research capacity building to develop sustainable careers in mental health research in African countries. International Journal of Mental Health Systems, 14(1):66. https://doi.org/10.1186/s13033-020-00388-1

[24] Lewis-Fernández, R., Rotheram-Borus, M.J., Betts, V.T., Greenman, L., Essock, S.M., Escobar, J.I., et al. (2016). Rethinking funding priorities in mental health research. The British Journal of Psychiatry, 208(6):507-509. https://doi.org/10.1192/bjp.bp.115.179895

[25] Mahomed, F. (2020). Addressing the problem of severe underinvestment in mental health and well-being from a human rights perspective. Health and Human Rights, 22(1):35-49.

[26] Marwick, K.F.M., & Kaaya, S.F. (2010). Prevalence of depression and anxiety disorders in HIV-positive outpatients in rural Tanzania. AIDS Care, 22(4):415-419. https://doi.org/10.1080/09540120903253981

[27] McKenzie-White, J., Mubuuke, A.G., Westergaard, S., Munabi, I.G., Bollinger, R.C., Opoka, R., et al. (2022). Evaluation of a competency based medical curriculum in a Sub-Saharan African medical school. BMC Medical Education, 22(1):724. https://doi.org/10.1186/s12909-022-03781-1

[28] Merritt, C., Jack, H., Mangezi, W., Chibanda, D., & Abas, M. (2019). Positioning for success: Building capacity in academic competencies for early-career researchers in Sub- Saharan Africa. Global Mental Health (Cambridge), 6:e16. https://doi.org/10.1017/gmh.2019.14

[29] Mremi, A., Pancras, G., Mrema, D., Morris, B., Mwakyandile, T., Msanga, D.R., et al. (2023). Mentorship of young researchers in resource-limited settings: Experiences of the mentees from selected health sciences Universities in Tanzania. BMC Medical Education, 23(1):375. https://doi.org/10.1186/s12909-023-04369-z

[30] Mushi, D., Francis, J.M., Moshiro, C., Hanlon, C., & Teferra, S. (2022). Integration of alcohol use disorder interventions in general health care settings in Sub-Saharan Africa: A scoping review. Frontiers in Psychiatry, 13:822791. https://doi.org/10.3389/fpsyt.2022.822791

[31] Nel, D., Burch, V., Adam, S., Ras, T., Mawela, D., Buch, E., et al. (2022). The introduction of competency-based medical education for postgraduate training in South Africa. South African Medical Journal, 112(9):742-743. https://doi.org/10.7196/SAMJ.2022.v112i9.16717

[32] Ng, S.L., Forsey, J., Boyd, V.A., Friesen, F., Langlois, S., Ladonna, K., et al. (2022). Combining adaptive expertise and (critically) reflective practice to support the development of knowledge, skill, and society. Advances in Health Sciences Education, 27(5):1265-1281. https://doi.org/10.1007/s10459-022-10178-8

[33] Njenga, F., Ongeri, L., Nguithi, A., Anundo, J., Mugane, M., Kimari, Z., et al. (2022). Integrating telepsychiatry services in a care setting in Kenya: A case report. BJPsych International, 19(2):E3. https://doi.org/10.1192/bji.2021.38

[34] Purtle, J., Nelson, K.L., Counts, N.Z., & Yudell, M. (2020). Population-based approaches to mental health: history, strategies, and evidence. Annual Review of Public Health, 41:201-221. https://doi.org/10.1146/annurev-publhealth-040119-094247

[35] Ranijiwala, A.H. (2024). The impact of poor mental health on productivity and suitable remedies. IJFMR - International Journal For Multidisciplinary Research, 6(4). https://doi.org/10.36948/ijfmr.2024.v06i04.25410

[36] Saade, S., Lamarche, A.P., Khalaf, T., Makke, S., & Legg, A. (2023). What barriers could impede access to mental health services for children and adolescents in Africa? A scoping review. BMC Health Services Research, 23(1):348. https://doi.org/10.1186/s12913-023-09294-x

[37] Ssewamala, F.M., McKay, M.M., Sensoy Bahar, O., Nabunya, P., Neilands, T., Kiyingi, J., et al. (2022). Suubi4 stronger families: A study protocol for a clustered randomized clinical trial addressing child behavioral health by strengthening financial stability and parenting among families in Uganda. Frontiers in Psychiatry, 13:693.

[38] Tully, I. (2022). Nothing about Us without Us: Inclusion and IRB review of mental health research protocols. Ethics and Human Research, 44(3):34-40. https://doi.org/10.1002/eahr.500128

[39] Wainberg, M.L., Scorza, P., Shultz, J.M., Helpman, L., Mootz, J.J., Johnson, K.A., et al. (2017). Challenges and opportunities in global mental health: A research-to-practice perspective. Current Psychiatry Reports, 19(5):28. https://doi.org/10.1007/s11920-017-0780-z

[40] Williams, L.D., Aber, J.L., & Group, S.R. (2019). The multilevel relationships of HIV-related stigma to child and caregiver mental health among HIV-affected households in South Africa. American Journal of Community Psychology, 63(1-2):3-16. https://doi.org/10.1002/ajcp.12280