Community Mental Health Service User Councils and Involuntary Admission Appeals in Kenyan Counties: A Difference-in-Differences Estimation of Participatory Governance Exposure

Community mental health service user councils are intended to give people with lived experience of mental illness a formal voice in decisions that affect them, including decisions about involuntary admission. Whether such councils actually change appeal behaviour at the county level has not been estimated. The design treats council establishment as the exposure, county-year appeal counts as the outcome, and county and year fixed effects as the identifying restrictions. It also reports the distribution of a related community-level indicator drawn from the Demographic and Health Surveys: family planning messages received at community meetings or events, measured across fifteen African country surveys between 2021 and 2025, with a mean of 29.733 and a standard deviation of 17.495. That indicator is used only to characterise the community-level information environment in which participatory governance operates, not as an outcome of council exposure. The contribution is a pre-specified estimation strategy for a question that policy has already answered by assumption.