Assessment of Family Dysfunction and Substance Use Disorder: Case of Inpatients at the Port Reitz Subcounty Hospital, Mombasa County, Kenya

Abstract

Substance Use Disorder (SUD) remains a significant public health challenge globally, regionally, and nationally. In Kenya, the problem is more pronounced in urban areas, with the coastal region identified as one of the most affected. Existing research highlights a complex interplay between substance use and family dysfunction; however, there is a notable gap in empirical studies examining this relationship within clinical settings in coastal Kenya. This study sought to assess the association between substance use disorder and family dysfunction among adult inpatients receiving treatment at Port Reitz Mental Hospital, Mombasa. The research was guided by Bowen’s Family Systems Theory (1978), which posits that individuals cannot be fully understood in isolation from their family unit, as dysfunction in one member often reflects broader systemic issues. A descriptive crosssectional research design was adopted, targeting 75 adult patients clinically diagnosed with SUD. Data were collected using the McMaster Family Assessment Device (FAD) to measure perceived family functioning across multiple domains, alongside a structured clinical records review form to capture socio-demographic characteristics and substance use history. The study explored how family dysfunction influences patterns of substance use, severity, and risk of relapse. Descriptive and inferential statistical analyses were conducted using SPSS version 27.0. The findings revealed a high prevalence of substance use disorder characterized by early onset, chronic use patterns, and widespread polysubstance involvement. The most commonly abused substances were cannabis (79.7%), khat (75.7%), and alcohol (54.1%). The results also indicated that a vast majority of participants (87.8%) came from dysfunctional or severely dysfunctional family systems, marked by breakdowns in communication, role clarity, affective involvement, problem solving, and behavioral control. Socio-demographic vulnerabilities—including youth, male gender, unemployment, and low educational attainment—were strongly associated with both substance use and family dysfunction. Furthermore, the relationship between substance use severity and family dysfunction was found to be substance- and domainspecific, underscoring the complexity of interactions between individual behavior and family systems. This study contributes to the growing body of knowledge on mental health and addiction in Kenya by providing empirical evidence from a clinical setting. The findings have practical implications for policymakers, clinicians, and rehabilitation practitioners, emphasizing the need for integrated treatment models that address both substance use and family dynamics. Strengthening family-centered interventions and socio-economic support systems can enhance recovery outcomes and inform more effective mental health strategies in Kenya’s coastal region.