Motivations and barriers for clinical mental health help-seeking in Bangladeshi university students: a cross-sectional study

Abstract

Background University and college students are vulnerable to developing depressive symptoms. People in low-income countries are disproportionately impacted by mental health problems, yet few studies examine routes to accessing clinical services. Examining motivation and barriers toward seeking clinical mental health services in university students in Bangladesh is important. Method Using a cross-sectional survey (n = 350), we assess the relationship between the constructs of autonomy, relatedness, and competency toward using clinical mental health practices (i.e. using professional resources, taking medication) with (1) positive views, (2) perceived need, and (3) use of clinical mental health services among Bangladeshi university students. Results Results showed that the perceived need for mental health support was the predictor of the largest magnitude (aOR = 4.99, p = 0.005) for using clinical services. Having a positive view of clinical services was predictive of clinical service use (aOR = 2.87, p = 0.033); however, that association became insignificant (p = 0.054) when adjusting for the perceived need for mental health care. Of the SDT constructs, social influences were predictive of perceiving a need for mental health support, and mental health knowledge was predictive (aOR = 1.10, p = 0.001) of having a positive view of clinical mental health care. Conclusion Our findings show that knowledge of mental health is associated with positive views of mental health services, and that higher levels of stress and the presence of people with mental health problems are associated with the perception of a need for mental health care, which is ultimately responsible for using the services.

University students’ use of mental health services: a systematic review and meta-analysis

“…The majority were from the United States, where 34 of the 44 studies were based [ 9 , 23 , 41 – 72 ]. The remainder from Australia [ 73 , 74 ], Brazil [ 75 , 76 ], China [ 77 ], Canada [ 78 ], Ethiopia [ 79 ], Bangladesh [ 28 ], and Italy [ 80 ]. A total of nineteen studies were samples of students from separate individual universities [ 43 , 46 , 48 – 55 , 67 , 68 , 70 , 73 , 75 – 77 , 79 , 80 ].…”

“…A total of nineteen studies were samples of students from separate individual universities [ 43 , 46 , 48 – 55 , 67 , 68 , 70 , 73 , 75 – 77 , 79 , 80 ]. Whereas the remaining twenty-four were samples across multiple universities [ 9 , 20 , 23 , 28 , 41 , 44 , 45 , 47 , 56 – 59 , 61 – 66 , 69 , 71 , 72 , 74 , 78 ].…”

“…Overall, most estimates were associated with services classified into the outpatient service category of the DESDE instrument (see Table 2 ). Seventy-four estimates associated with thirty-seven studies were outpatient services [ 9 , 20 , 28 , 41 , 43 – 52 , 54 , 55 , 57 , 59 , 61 – 67 , 70 – 73 , 75 – 80 ]. Thirty-seven estimates associated with twenty-two studies could be classed as multiple service categories [ 9 , 20 , 23 , 41 , 47 , 50 , 53 , 56 , 57 , 61 – 66 , 68 – 71 , 74 , 78 ].…”

“…One recent international cross-sectional study found 19.8% of first year university students, and 36% of those who may meet criteria for CMD report having ever used a mental health service, defined as medication or psychological counselling [ 6 ]. Compared to HICs, much less is known about students in Lower and Middle Income Countries (LMIC), although individual studies suggest very small numbers of students report accessing support when in distress [ 18 , 28 ].…”

A qualitative exploration of university student perspectives on mindfulness-based stress reduction exercises via smartphone app in Bangladesh

“…In Asia, there is documented widespread stigma surrounding mental health; however, few studies have examined the Bangladeshi views on mental health. One study in a University student sample in Bangladesh found that stigma was not significantly associated with reduced utilization of clinical mental health services; however, it is essential to note that the sample had low levels of stigma overall (Sifat, Tasnim, et al, 2022b ). However, in a systematic review on this topic, it was found that a majority of the community does not recognize mental illness, that attitudes regarding treatment are negative, and that even those with mental illness do not see treatment as a priority (Hossain et al, 2014 ).…”