Articlegold2020

Can Mobile Health Improve Depression Treatment Access and Adherence Among Rural Indian Women? A Qualitative Study

Amritha S Bhat · B. Ramakrishna Goud · Johnson Pradeep Ruben · Geetha Jayaram · Rajiv Radhakrishnan · Krishnamachari Srinivasan

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Digital Mental Health Interventions Mental Health Treatment and Access Mobile Health and mHealth Applications

Abstract

Introduction: Low rates of follow up with mental health treatments, and medication non-adherence are common among patients with Major Depressive Disorder (MDD), more so in low-middle income countries (LMIC). While mobile mental health has the potential to address this problem in resource-poor settings, the feasibility and acceptability of its use in rural women is unknown. We aimed to explore barriers to access and adherence to mental health treatment, and the feasibility of using mobile health to address these barriers among women with MDD in rural south India. Methods: Six focus groups were conducted among women with MDD (n=69) seeking care at a rural community health center in South India. Discussion centered on barriers to mental health treatment access and adherence and attitudes toward use of technology in addressing these barriers. We transcribed the discussions and analyzed them using qualitative analysis software. Results: Reasons for non-adherence were: transcultural explanatory model of illness; structural, financial and social barriers to access, and medication side-effects. Women were unenthusiastic about mobile health solutions due to illiteracy, lack of family support, unfamiliarity with use of mobile devices, lack of access to mobile phones and preference for in-person clinical consultation. Conclusions: This qualitative study examines the acceptability of mobile-mental health as a strategy to address barriers to depression treatment access and adherence among women in a rural setting. There are several barriers to adoption of mobile mental health technology in LMIC. It is important to address these barriers before implementing mobile health based solutions.

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References

2005Three Approaches to Qualitative Content Analysis 1998Basics of qualitative research : techniques and procedures for developing grounded theory 2010Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory 2013Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010 2013Traveling Towards Disease: Transportation Barriers to Health Care Access 2015Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities, 3rd edition 2017National mental health survey of India 2015–2016 2013Grand Challenges: Integrating Mental Health Services into Priority Health Care Platforms

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2024Feasibility and utility of mobile health interventions for depression and anxiety in rural populations: A scoping review 2022Connected Mental Health Solutions: Global Attitudes, Preferences, and Concerns 2023Mobile Mental Health in Women’s Community-Based Organizations: Protocol for a Pilot Randomized Controlled Trial 2025Development of a Multiuser Interactive Health Response Application (MITHRA) for depression in women from a community-based organisation in India

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