Community Mental Health Worker Caseload Caps and Crisis Relapse Detection in Kenyan Community Units: A Regression-Discontinuity Estimation of Surveillance-Intensity Exposure
Year: 2026
Type: article
Abstract: Kenyan community units assign each community mental health worker a fixed caseload ceiling, yet the surveillance consequences of that ceiling have not been estimated. the present analysis treats the caseload cap as a regression-discontinuity assignment mechanism: workers whose enrolled caseload falls just below the cap retain intensive follow-up, while those just above it shift to a thinner surveillance regime. Using the DHS Program indicator 'Family planning messages at community meeting or event' (FP_EFPM_M_COM) across 15 African country surveys fielded between 2021 and 2025 (N = 15; mean = 29.733; SD = 17.495; range 6.60 in Mali to 73.40 in Malawi), the analysis specifies the discontinuity estimator that would identify the effect of surveillance-intensity exposure on crisis relapse detection. The design parameters, the running variable, the bandwidth logic and the exclusion restriction are stated formally. It does not report causal estimates; it reports the conditions under which such estimates would be credible.
Institution: University of Nairobi
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7223196428