Amplifying Coaches’ voices from the implementation of the MindSKILLZ youth mental health program in Kenya: A critical discourse analysis

Young implementers bring valuable insights that can help inform and create effective mental health support systems and interventions tailored to their needs and unique experiences. However, their perspectives are often overlooked. This qualitative study analysed discourses from community role models, referred to as MindSKILLZ Coaches. We hosted five focus group discussions and collected 30 personal stories journaled by MindSKILLZ Coaches in Nairobi and Mombasa counties between August 2023 and March 2024. We were interested in understanding their experiences implementing a mental health intervention for young people during a pilot study, including any perceived program impacts on Coaches themselves and youth participants.This was done to identify implementation successes and challenges, improve use of language in developing materials for program implementation, strengthen institutional guidelines for learning materials and generate evidence to inform future program delivery, adaptation and scale-up. Data were analysed using Fairclough's Model for Critical Discourse Analysis to examine three interconnected discourses: 1) textual practice (micro level), 2) discursive practice (meso level), and 3) social practice (macro level). Across these levels, we looked at how discourse contributes to the maintenance of social power relations, ideologies, and institutional practices. Findings revealed that the MindSKILLZ program positively impacted the Coaches and youth participants by improving self-esteem, use of creative approaches to reach persons with disability, and improvement of academic performance, all of which facilitated successful program implementation overall. Institutional practices (e.g., assumptions of uniform cultural practices among participants), structural power imbalances (e.g., limitations on Coaches' roles in program implementation) and social relations (e.g., Coaches simplified language reinforcing their authority) limited the program's effectiveness. Amplifying the Coaches' voices enhances adoption of a grassroots perspective, which can challenge unequal power dynamics. The use of grassroots insights can aid in co-creating more equitable and effective mental health interventions.