A qualitative analysis of health care provider perceptions of depression and suicidality in Mozambique

Thesis (Master's)--University of Washington, 2016-06

Aim: The purpose of this study is to identify and describe health care provider explanatory models, beliefs, attitudes, and practices regarding depression and suicidality in Sofala Province, Mozambique. Background: There is currently limited knowledge about the prevalence of mental health conditions in Mozambique, particularly regarding more common mental disorders such as depression. Mozambique was recently listed as having the 7th highest suicide rate in the world. A lack of data and available treatment for common mental disorders contributes to cycles of poor mental health and poor physical health, while impeding efforts to improve access and availability of culturally appropriate mental health care in Mozambique. There is minimal qualitative research regarding stigma related to mental health in Sub-Saharan Africa. Methods: We targeted health care providers to serve as key informants based on their respective mental health care knowledge. An in-depth interview (IDI) guide was used in conducting 25 semi-structured interviews of clinical providers knowledgeable on mental health in the community, and providers working in units with both high patient contact and high potential for depression and/or suicidal ideation. Findings: Analysis revealed that most providers perceive a high prevalence of depression and suicide, with both of these issues cited as a mental health concern that should be treated. Providers indicated that patients had a limited knowledge of mental health services, and expressed a desire for increased training themselves. Isolation, familial and relationship conflict, and HIV diagnosis were common causes for depression and poor mental health, and many providers suggested a need for incorporating community and families in treatment. Conclusion: There is a need to address stigma reduction by means of community education around mental health care, and health care provider knowledge of and comfort addressing depression and suicidality. Linkages should be strengthened between HIV care and mental health care.