Background
Methods
Study design, study population and sample size
Data collection procedures
Measurements
Statistical analysis
Ethical statement
Results
Socio-demographic and psycho-social factors
Total population (with and without depression and/or suicidality) | Population with depression and/or suicidality | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Men (n = 440) | Women (n = 477) |
p value* | Men (n = 78) | Women (n = 169) |
p value* | |||||
n
| % |
n
| % |
n
| % |
n
| % | |||
Respondents’ characteristics | ||||||||||
1. Age groups | ||||||||||
20–24 years | 148 | 33.8 | 127 | 27.0 | 0.050 | 23 | 29.5 | 51 | 30.5 | 0.666 |
25–29 years | 144 | 32.9 | 156 | 33.2 | 31 | 39.7 | 57 | 34.1 | ||
30–35 years | 146 | 33.3 | 187 | 39.8 | 24 | 30.8 | 59 | 35.3 | ||
2. Marital status | ||||||||||
Married or cohabiting | 236 | 53.8 | 342 | 72.3 | 0.000 | 41 | 53.2 | 116 | 68.6 | 0.000 |
Divorced or widowed | 2 | 0.5 | 33 | 7.0 | 1 | 1.3 | 16 | 9.5 | ||
Single | 201 | 45.8 | 98 | 20.7 | 35 | 45.5 | 37 | 21.9 | ||
3. Education level | ||||||||||
Secondary school or university | 50 | 13.3 | 67 | 17.0 | 0.006 | 8 | 10.7 | 27 | 16.2 | 0.531 |
Complete primary school or vocational training | 105 | 28.0 | 73 | 18.6 | 10 | 13.3 | 21 | 12.6 | ||
Incomplete primary school | 220 | 58.7 | 253 | 64.4 | 57 | 76.0 | 119 | 71.3 | ||
Partner’s characteristics | ||||||||||
4. Ever been to school | ||||||||||
Attended school | 211 | 83.7 | 287 | 75.9 | 0.021 | 38 | 79.2 | 95 | 72.0 | 0.443 |
Partner no schooling | 41 | 16.3 | 91 | 24.1 | 10 | 20.8 | 37 | 28.0 | ||
Household (HH) characteristics | ||||||||||
5. Assets in the household | ||||||||||
Have at least 1 of the assets | 323 | 73.4 | 331 | 69.4 | 0.189 | 48 | 61.5 | 100 | 59.2 | 0.781 |
Have none of the HH assets | 117 | 26.6 | 146 | 30.6 | 30 | 38.5 | 69 | 40.8 |
Help-seeking behaviours for mental health care
Total (n = 247) | Men (n = 78) | Women (n = 169) |
p value* | ||||
---|---|---|---|---|---|---|---|
n
| % |
n
| % |
n
| % | ||
1. Help-seeking for emotional problems? | |||||||
Yes | 150 | 60.7 | 43 | 55.1 | 107 | 63.3 | 0.262 |
No | 97 | 39.3 | 35 | 44.9 | 62 | 36.7 |
Total (n = 150) | Men (n = 43) | Women (n = 107) |
p value* | ||||
---|---|---|---|---|---|---|---|
2. Seeking help in a health care unit? | |||||||
To a health centre or district hospital | 38 | 25.3 | 8 | 18.6 | 30 | 28.0 | |
To a district hospital to see mental health professional | 5 | 3.3 | 1 | 2.3 | 4 | 3.7 | |
To a mental health clinic/mental hospital | 1 | 0.6 | 0 | 0.0 | 1 | 0.9 | |
To a private clinic | 11 | 7.3 | 5 | 11.6 | 6 | 5.6 | |
Visited at least one of the above health care units) | 54 | 36.0 | 13 | 30.2 | 41 | 38.3 | 0.236 |
3. Seeking help from others (other source of support)? | |||||||
Wife/Partner | 11 | 7.3 | 2 | 4.7 | 9 | 8.4 | |
Parent | 12 | 8.0 | 3 | 7.0 | 9 | 8.4 | |
Other relative | 13 | 8.7 | 5 | 11.6 | 8 | 7.5 | |
Friend | 36 | 24.0 | 10 | 23.3 | 26 | 24.3 | |
Teacher | 2 | 1.3 | 1 | 2.3 | 1 | 0.9 | |
Religious person | 9 | 6.0 | 4 | 9.3 | 5 | 4.7 | |
Community health worker | 14 | 9.3 | 1 | 2.3 | 13 | 12.1 | |
Traditional healer or traditional birth attendant | 10 | 6.7 | 3 | 7.0 | 7 | 6.5 | |
Visited at least one of the above sources of support | 96 | 64.0 | 25 | 58.1 | 71 | 66.4 | 0.477 |
Barriers to care
Variables | Total | Men | Women |
p value* | |||
---|---|---|---|---|---|---|---|
n
| % |
n
| % |
n
| % | ||
1. Structural barriers | |||||||
It was too far away to get there | 14 | 5.7 | 1 | 1.3 | 13 | 7.7 | 0.071 |
There was no transport available | 35 | 14.2 | 6 | 7.7 | 29 | 17.2 | 0.051 |
I could not afford to pay the transport costs | 39 | 15.8 | 9 | 11.5 | 30 | 17.8 | 0.262 |
I could not pay the fee at the health care centre | 42 | 17.0 | 10 | 12.8 | 32 | 18.9 | 0.277 |
I have no insurance | 43 | 17.4 | 10 | 12.8 | 33 | 19.5 | 0.212 |
Summary measure (at least exposed to one of the barriers) | 52 | 21.1 | 10 | 12.8 | 42 | 24.9 | 0.043 |
2. Individual barriers related to knowledge and attitudes | |||||||
I did not know where to go for treatment | 29 | 11.7 | 4 | 5.1 | 25 | 14.8 | 0.033 |
I was too embarrassed to discuss my problems with anyone | 28 | 11.3 | 7 | 9.0 | 21 | 12.4 | 0.520 |
I did not believe that I would get proper treatment | 37 | 15.0 | 6 | 7.7 | 31 | 18.3 | 0.034 |
I did not believe that treatment could help me | 34 | 13.8 | 5 | 6.4 | 29 | 17.2 | 0.028 |
I thought my problem was one I should be able to cope with myself | 34 | 13.8 | 12 | 15.4 | 22 | 13.0 | 0.692 |
I thought that the problem would disappear by itself | 28 | 11.3 | 14 | 17.9 | 14 | 8.3 | 0.032 |
I was afraid of the consequences of seeking care (treatment, tests, hospitalization, operations…) | 15 | 6.1 | 4 | 5.1 | 11 | 6.5 | 0.781 |
I did not want any help | 12 | 4.9 | 2 | 2.6 | 10 | 5.9 | 0.349 |
I got help from another source | 26 | 10.5 | 7 | 9.0 | 19 | 11.2 | 0.662 |
Other responsibility such as taking care of children/family members | 17 | 6.9 | 3 | 3.8 | 14 | 8.4 | 0.282 |
Summary measure (at least exposed to one of the barriers) | 67 | 27.1 | 17 | 21.8 | 50 | 29.6 | 0.221 |
3. Stigma-related barriers | |||||||
I was afraid that somebody I knew would see me at the health care clinic | 6 | 2.4 | 4 | 5.1 | 2 | 1.2 | 0.081 |
I was ashamed to show others how emotionally troubled I was | 9 | 3.6 | 4 | 5.1 | 5 | 3.0 | 0.469 |
I was afraid that the health care staff would have negative attitudes towards me | 11 | 4.5 | 5 | 6.4 | 6 | 3.6 | 0.331 |
I was afraid to bring bad name to my family if I disclosed to health staff that I felt emotionally troubled | 11 | 4.5 | 5 | 6.4 | 6 | 3.6 | 0.331 |
I did not trust that health staff will keep my problem confidential | 7 | 2.8 | 4 | 5.1 | 3 | 1.8 | 0.212 |
Summary measure (at least exposed to one of the barriers) | 14 | 5.7 | 6 | 7.7 | 8 | 4.7 | 0.381 |
Variables | Men | Women | ||||||
---|---|---|---|---|---|---|---|---|
Structural barriers | Individual barriers | Structural barriers | Individual barriers | |||||
n (%) with exp. | OR (95 % CI) |
n (%) with exp. | OR (95 % CI) |
n (%) with exp. | OR (95 % CI) |
n (%) with exp. | OR (95 % CI) | |
Respondent’s age | ||||||||
20–24 years | 4 (17.4) | 1 | 5 (21.7) | 1 | 10 (19.6) | 1 | 15 (29.4) | 1 |
>24 years | 6 (10.9) | 0.58 (0.15–2.29) | 12 (21.8) | 1.01 (0.31–3.27) | 32 (27.6) | 1.56 (0.70–3.48) | 35 (30.2) | 1.04 (0.50–2.13) |
Respondent’s education | ||||||||
Complete primary or secondary school or vocational training or university | 9 (15.8) | 1 | 13 (22.8) | 1 | 34 (28.6) | 1 | 36 (30.3) | 1 |
Incomplete primary or no schooling | 1 (5.6) | 3.19 (0.38–27.06) | 4 (22.2) | 1.03 (0.29–3.69) | 8 (16.0) | 2.10 (0.89–4.93) | 14 (28.0) | 1.12 (0.54–2.32) |
Partner’s ever been to school | ||||||||
Yes | 5 (13.2) | 1 | 6 (15.8) | 1 | 19 (20.0) | 1 | 28 (29.5) | 1 |
No | 2 (20.0) | 1.65 (0.27–10.1) | 3 (30.0) | 2.29 (0.46–11.43) | 17 (45.9) | 3.40 (1.50–7.71) | 15 (40.5) | 1.63 (0.74–3.60) |
Assets in the household | ||||||||
Yes | 5 (10.4) | 1 | 9 (18.8) | 1 | 19 (19.0) | 1 | 27 (27.0) | 1 |
No | 5 (16.7) | 1.72 (0.45–6.53) | 8 (26.7) | 1.58 (0.53–4.67) | 23 (33.3) | 2.13 (1.05–4.32) | 23 (33.3) | 1.35 (0.69–2.64) |
Self-efficacy for seeking mental health care
Self-efficacy for seeking care | Population not reporting any of the mental disorders investigated* (n = 502, men: n = 271 and women, n = 231) | Population with depression and/or suicidality (n = 247, men: n = 78 and women, n = 169) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Men | Women |
p value** | Men | Women |
p value** | |||||
If you need mental health care, I feel confident in my ability to: | Low confidence | High confidence | Low confidence | High confidence | Low confidence | High confidence | Low confidence | High confidence | ||
n (%) |
n (%) |
n (%) |
n (%) |
n (%) |
n (%) |
n (%) |
n (%) | |||
1. Knowledge | ||||||||||
Find a place to get mental health treatment | 95 (35.4) | 71 (26.5) | 100 (43.7) | 75 (32.8) | 0.185 | 29 (37.7) | 23 (29.9) | 96 (57.5) | 42 (25.1) | 0.007 |
Get transportation to mental health care service | 111 (41.7) | 59 (22.2) | 112 (48.5) | 56 (24.2) | 0.208 | 44 (57.9) | 15 (19.7) | 104 (62.3) | 31 (18.6) | 0.053 |
Pay for the transportation to mental health care service | 101 (47.9) | 34 (16.1) | 99 (49.3) | 41 (20.4) | 0.183 | 36 (50.0) | 13 (18.1) | 100 (69.4) | 18 (12.5) | 0.006 |
Pay the fee for the mental health care service, if there is one | 135 (51.1) | 50 (18.9) | 109 (48.7) | 34 (15.2) | 0.387 | 44 (59.5) | 10 (13.5) | 115 (69.3) | 22 (13.3) | 0.005 |
Clearly tell the staff what is troubling me | 42 (15.8) | 74 (27.8) | 57 (24.8) | 73 (31.7) | 0.550 | 13 (17.1) | 28 (36.8) | 43 (25.7) | 84 (50.3) | 0.092 |
Understand the information given to me by the staff | 35 (13.2) | 117 (44.0) | 31 (13.4) | 87 (37.7) | 0.983 | 7 (9.1) | 40 (51.9) | 18 (10.8) | 97 (58.4) | 0.018 |
Be able to follow the treatment recommendations made by the staff | 25 (9.3) | 142 (53.0) | 25 (10.9) | 107 (46.7) | 0.952 | 5 (6.6) | 43 (56.6) | 12 (7.2) | 105 (63.3) | 0.005 |
2. Coping | ||||||||||
Cope well with the consequences of seeking care | 25 (9.3) | 133 (49.4) | 25 (10.9) | 104 (45.2) | 0.554 | 5 (6.5) | 37 (48.1) | 13 (7.8) | 95 (56.9) | 0.019 |
Cope well with family or friends’ reactions to me seeking mental health treatment | 32 (11.9) | 137 (51.1) | 19 (8.2) | 115 (49.8) | 0.607 | 11 (14.3) | 38 (49.4) | 16 (9.6) | 100 (59.9) | 0.007 |
Cope well with the attitudes that the staff may have towards me | 28 (10.4) | 137 (51.1) | 23 (10.0) | 114 (49.4) | 0.513 | 7 (9.3) | 34 (45.3) | 16 (9.6) | 110 (65.9) | 0.000 |
Overcome any embarrassment I may have about seeking mental health treatment | 32 (12.0) | 133 (49.8) | 44 (19.0) | 111 (48.1) | 0.278 | 12 (15.6) | 40 (51.9) | 23 (13.8) | 101 (60.5) | 0.046 |