Gender-Based and Domestic Violence as a Determinant of Mental Health in Kenya: A Quantitative Integrative Review with Implications for Culturally Responsive Clinical Practice

Abstract

Gender-based violence (GBV) and domestic violence (DV) constitute pervasive public health and human rights concerns in Kenya, with substantial yet often under-recognized implications for mental health. This quantitative integrative review synthesizes empirical evidence examining GBV/DV as determinants of psychological distress and translates these findings into culturally responsive clinical practice recommendations. Guided by ecological, feminist, and trauma-informed frameworks, the review contextualizes mental health outcomes within intersecting relational, community, and structural dynamics. A systematic search of peer-reviewed literature (2010–2025) identified thirteen quantitative studies conducted across diverse Kenyan settings, including urban informal settlements, rural counties, and refugee contexts. Findings indicate consistently high prevalence of violence, with lifetime intimate partner violence affecting approximately 41–52% of women. Strong statistical associations were observed between GBV/DV exposure and adverse mental health outcomes, including elevated odds of PTSD, depression, anxiety, and increased risk of substance use and suicidality. Evidence further highlights systemic under-detection of violence within healthcare settings, contributing to fragmented care and misinterpretation of trauma-related symptoms. Structural factors, including gender inequality, economic dependence, stigma, and limited access to coordinated services, were identified as key determinants shaping both exposure to violence and mental health outcomes. The review underscores the need for integrated, trauma-informed, and culturally responsive clinical approaches in Kenya, with implications outlined across assessment, formulation, intervention, and clinician supervision.