Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Clinical Research Education Networking and Consultancy, Yaounde, Cameroon.
BMC Psychiatry. 2021 Jun 5;21(1):293. doi: 10.1186/s12888-021-03306-y.
Mental health and substance use disorders (MSDs) increase the risk of poor human immunodeficiency virus (HIV) care outcomes among people living with HIV (PLWH). Receipt of mental health care may improve these adverse outcomes. We aimed to identify correlates of prior mental health help-seeking among PLWH with symptoms of an MSD in Cameroon.
We characterize prior mental health help-seeking from formal (mental health specialist/general medical provider) and informal (traditional healer/religious leader) sources among 161 people with symptoms of depression (Patient Health Questionnaire-9 scores> 9), anxiety (General Anxiety Disorder-7 scores> 9), probable post-traumatic stress disorder (PTSD Checklist for DSM-5 scores> 30), or possible alcohol use disorder (Alcohol Use Disorders Identification Test scores≥16) who were newly entering HIV care at three healthcare facilities in Cameroon between June 2019 and March 2020. Help-seeking was defined as ever speaking to a formal or informal source about emotional problems, sadness, or the way they were feeling or behaving. We estimated the association between sociodemographic and psychosocial measures and lifetime mental health help-seeking from each type of source using log-binomial regression.
Overall, 55.3% of 161 PLWH with MSD symptoms reported prior mental health help-seeking, with 24.2% and 46.0% seeking help from formal and informal sources, respectively. Religious leaders were the most common source of help (40.4%), followed by general medical professionals (22.4%), traditional healers (16.8%), and mental health specialists (7.4%). Individuals with higher depressive, anxiety, and trauma symptom severity scores were more likely to have sought help than those with lower scores. Individuals with possible alcohol use disorder were the least likely to have sought help. Prior help-seeking was more common among those reporting a higher number of lifetime traumatic events (prevalence ratio [PR]: 1.06; 95% confidence interval [CI]: 1.01, 1.11) and those with a history of emotional intimate partner violence (PR: 1.34; 95% CI: 1.01, 1.80).
Prior mental health help-seeking was associated with psychosocial stressors. Help-seeking from informal networks was more common than formal help-seeking. Training in the provision of evidence-based mental health support for informal networks could improve access to mental health care for PLWH with MSDs in Cameroon.
精神健康和物质使用障碍（MSD）会增加艾滋病毒感染者（PLWH）不良艾滋病毒护理结局的风险。接受精神健康护理可能会改善这些不良结局。我们的目的是确定喀麦隆有 MSD 症状的 PLWH 寻求精神健康帮助的相关因素。
我们描述了 161 名有抑郁症状（患者健康问卷-9 评分>9）、焦虑（一般焦虑障碍-7 评分>9）、可能创伤后应激障碍（DSM-5 创伤后应激障碍检查表评分>30）或可能酒精使用障碍（酒精使用障碍识别测试评分≥16）的 PLWH 在喀麦隆三家医疗保健机构新进入艾滋病毒护理时，从正式（精神健康专家/一般医疗提供者）和非正式（传统治疗师/宗教领袖）来源寻求精神健康帮助的情况。寻求帮助的定义是曾经与正式或非正式来源谈论过情绪问题、悲伤或他们的感受或行为方式。我们使用对数二项式回归估计了社会人口统计学和心理社会测量指标与每种来源的终身精神健康帮助寻求之间的关联。
总体而言，161 名有 MSD 症状的 PLWH 中，有 55.3%报告有过精神健康帮助寻求，其中 24.2%和 46.0%分别从正式和非正式来源寻求帮助。宗教领袖是最常见的帮助来源（40.4%），其次是一般医疗专业人员（22.4%）、传统治疗师（16.8%）和精神健康专家（7.4%）。抑郁、焦虑和创伤症状严重程度得分较高的个体比得分较低的个体更有可能寻求帮助。有潜在酒精使用障碍的个体最不可能寻求帮助。报告更多的终生创伤事件（优势比 [PR]：1.06；95%置信区间 [CI]：1.01，1.11）和有情感亲密伴侣暴力史的个体（PR：1.34；95%CI：1.01，1.80）更有可能寻求帮助。
既往精神健康帮助寻求与心理社会压力因素有关。寻求非正式网络的帮助比寻求正式帮助更为常见。为非正式网络提供基于证据的精神健康支持的培训可以改善喀麦隆有 MSD 的 PLWH 的精神卫生保健获取。
