乌干达青少年抑郁症治疗和护理的障碍：心理健康素养的作用。
Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy.
机构信息
Department of Psychology, Kyambogo University, Kampala, Uganda.
Department of Public Health, Lira University, Lira, Uganda.
出版信息
Front Public Health. 2023 Mar 2;11:1054918. doi: 10.3389/fpubh.2023.1054918. eCollection 2023.
BACKGROUND
Depression represents a significant mental health problem (MHP) in low- and middle-income countries (LMICs), especially among early adults. Nevertheless, most early adults with depression do not seek treatment. Failure to recognize depression and knowledge about mental health literacy (MHL) may contribute to poor help-seeking behavior. This study assessed MHL, access and barriers to mental health care for depression among early adults in Uganda.
METHODS
Data were collected from students in two of the largest universities in Uganda. Participants completed questionnaires on depression, MHL, sources of barriers and opportunities for MH service. Regression analyses and parametric tests were used to assess depression, access, barriers and opportunities to promote MH.
RESULTS
About 12 per cent ( = 56) of the respondents were at the level of moderately severe to severe depression. Mental health literacy (MHL) scores were generally low ranging from "Ability to recognize mental disorders" ( = 19.32, 3.22, 18-32), and "Knowledge of risk factors" ( = 4.39, 1.17, 2-8), and "Knowledge of available information" ( = 9.59, 2.53, 5-20). Respondents reported barriers such as "stigma/discrimination" (65.53%), "lack of knowledge of where to receive help" (65.15%), "lack of trust in health workers" (62.56%), and "distant health facilities" (19.70%) that impede access to treatment and care. MHL significantly predicted depression (based on a continuous scale) ( = 0.63, 95% confidence interval [CI]: [0.56, 0.70]) with the regression model yielding a significant fit [ = 0.40, (2, 460) = 189.84, < 0.001].
CONCLUSIONS
MHL is low among university students amidst several barriers such as stigma, fear, and lack of trust. To attenuate the negative effects of MHPs on wellbeing and lower the increased risk of psychopathology into adulthood, it is critical to prioritize MHL, address barriers to treatment and care, and develop the requisite infrastructure to tackle depression among early adults.
背景
抑郁症是低收入和中等收入国家（LMICs）的一个重大心理健康问题（MHP），尤其在青年中更为常见。然而，大多数患有抑郁症的青年并未寻求治疗。对抑郁症的认识不足以及心理健康素养（MHL）的知识可能导致寻求帮助的行为不佳。本研究评估了乌干达青年中抑郁症的 MHL、获得和获得精神卫生保健的障碍。
方法
数据来自乌干达两所最大大学的学生。参与者完成了关于抑郁症、MHL、障碍来源和促进 MH 服务机会的问卷。回归分析和参数检验用于评估促进 MH 的抑郁、获得、障碍和机会。
结果
大约 12%（=56）的受访者处于中度至重度抑郁水平。心理健康素养（MHL）得分普遍较低，范围从“识别精神障碍的能力”（=19.32，3.22，18-32）和“风险因素知识”（=4.39，1.17，2-8），以及“可用信息知识”（=9.59，2.53，5-20）。受访者报告了一些障碍，例如“污名/歧视”（65.53%）、“不知道在哪里寻求帮助”（65.15%）、“不信任卫生工作者”（62.56%）和“医疗机构偏远”（19.70%），这些障碍阻碍了治疗和护理的获得。MHL 显著预测抑郁（基于连续量表）（=0.63，95%置信区间[CI]：[0.56，0.70]），回归模型得出的拟合度显著[=0.40，（2，460）=189.84，<0.001]。
结论
大学生的 MHL 较低，存在污名化、恐惧和缺乏信任等多种障碍。为了减轻心理健康问题对幸福感的负面影响，并降低青年进入成年期后患精神病理学的风险增加，优先考虑 MHL、解决治疗和护理障碍以及开发必要的基础设施来解决青年中的抑郁症至关重要。
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