Professional Quality of Life Among Non-Specialist Healthcare Workers Trained in Child and Adolescent Mental Health in Kenya: A Mixed-Methods Study.

PURPOSE: To evaluate the effects of child and adolescent mental health training on professional quality of life and to explore contextual factors influencing these outcomes among non-specialist healthcare workers in Kenya. METHODS: A mixed-methods pre-post implementation evaluation with an explanatory qualitative follow-up was conducted. Quantitatively, 92 non-specialist healthcare workers were assessed pre-training and 65 at the 3-month follow-up using the Professional Quality of Life Scale-5 (ProQOL-5), measuring compassion satisfaction, burnout, and secondary traumatic stress. All participants completed a 5-day training on child and adolescent mental and behavioral disorders (CAMBD). Regression analyses examined changes in ProQOL outcomes. Qualitatively, five focus group discussions (n=5) were conducted with a purposive subset of trained participants (n=60) to explore contextual influences on workforce well-being. RESULTS: Despite significant improvements in knowledge, no significant changes were observed across the ProQOL subscales between pre-training and follow-up (p-values 0.56-0.74). Greater knowledge gain was associated with lower secondary traumatic stress (r =- 0.29, p = 0.02). Qualitative findings revealed persistent systemic constraints, including high patient volumes, weak referral pathways, medication shortages, and a lack of career advancement, that undermine workforce well-being. Participants described moral distress arising from the inability to provide adequate CAMBD care or to translate newly acquired skills into practice, despite enhanced competence. CONCLUSION: While mental health training improved knowledge, professional quality of life among non-specialist healthcare workers remained largely unchanged. Findings suggest that workforce well-being in task-sharing mental healthcare is strongly shaped by health system constraints, underscoring the need for structural interventions alongside capacity-building.