Dhaka, the capital of Bangladesh, is the eleventh largest megacity city in the world, with a population of 18.2 million people living in an area of 1528 km 2 . This city profile traces the trajectories of its urban development to becoming a megacity and characterizes its emerging challenges due to informal urbanization and climate change impacts. Due to rapid population growth and uncontrolled urbanization, Dhaka currently faces various socio-economic and environmental challenges in aspects such as providing basic urban services; reliable transportation framework; constant water and energy supply; effective sanitation; sustainable waste management and affordable housing. Moreover, the urban setting has further deteriorated as Dhaka is already facing various adverse impacts of climate change. Studies predict that most of the urban sectors, public health and surrounding agriculture and fisheries in Dhaka will be severely impacted by climate change. Dhaka is trying to transform its existing "incremental development" model to an "integrated development" framework in order to effectively mitigate its extreme urban challenges. The future of Dhaka city significantly relies on the successful execution of integrated infrastructure and service planning, development, and management practices, operating under an accountable and good governance system.
Background The mental health of healthcare professionals is reaching a breaking point, and the COVID-19 pandemic has exacerbated current mental health issues to unprecedented levels. Whilst some research has been carried out on the barriers that doctors face when seeking mental health help, there is little research into factors which may facilitate seeking help. We aimed to expand the research base on factors which act as barriers to seeking help, as well as gain insight into facilitators of help-seeking behaviour for mental health in NHS doctors. Methods We conducted a systematic literature review which identified the barriers and facilitators to seeking help for mental health in healthcare professionals. Following this, we conducted semi-structured interviews with 31 NHS doctors about their experiences with mental health services. Finally, through thematic analysis, key themes were synthesised from the data. Results Our systematic literature review uncovered barriers and facilitators from pre-existing literature, of which the barriers were: preventing actions, self-stigma, perceived stigma, costs of seeking treatment, lack of awareness and availability of support, negative career implications, confidentiality concerns and a lack of time to seek help. Only two facilitators were found in the pre-existing literature, a positive work environment and availability of support services. Our qualitative study uncovered additional barriers and facilitators, of which the identified barriers include: a negative workplace culture, lack of openness, expectations of doctors and generational differences. The facilitators include positive views about mental health, external confidential service, better patient outcomes, protected time, greater awareness and accessibility, open culture and supportive supervisors. Conclusion Our study began by identifying barriers and facilitators to seeking mental health help in healthcare workers, through our systematic literature review. We contributed to these findings by identifying themes in qualitative data.. Our findings are crucial to identify factors preventing NHS doctors from seeking help for their mental health so that more can be done on a national, trust-wide and personal level to overcome these barriers. Likewise, further research into facilitators is key to encourage doctors to reach out and seek help for their mental health.
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