背景:与男性发生性关系(MSM)的男性因心理健康状况不佳而承担了不成比例的负担。尽管负担越来越大,在尼泊尔,针对MSM的循证干预措施基本上不存在。
目的:本研究探讨了心理健康问题,促成因素,心理保健和支持的障碍,和首选干预措施,以改善尼泊尔MSM获得和使用心理健康支持服务的机会。
方法:我们在加德满都与MSM进行了焦点小组,尼泊尔,2023年1月。总的来说,28名参与者参加了5次焦点小组会议。与会者讨论了与他们所经历的心理健康问题有关的几个主题,导致这些问题的因素,以及他们对解决现有障碍的潜在干预措施的建议。讨论被记录下来,转录,并使用Dedoose(9.0.54版;社会文化研究顾问,LLC)专题分析软件。
结果:参与者报告了严重的心理健康问题,包括焦虑,抑郁症,自杀意念,和行为。促成因素包括家庭排斥,隔离,欺凌,污名,歧视,以及对艾滋病毒和其他性传播感染的恐惧。获得服务的障碍包括成本,缺少女同性恋,同性恋,双性恋,变性人,双性人,酷儿,和无性(LGBTIQA+)友好的提供者,以及与心理健康和性行为相关的耻辱。参与者建议使用具有心理健康筛查工具等功能的智能手机应用程序,数字咨询,帮助热线号码,LGBTIQA+友好提供商的目录,心理健康资源,以及作为潜在解决方案的同行支持讨论论坛。与会者强调了隐私和保密的重要性,以确保移动应用程序是安全和可访问的。
结论:这项研究的结果对面临类似挑战的其他低资源环境具有潜在的可转移性。干预开发人员可以使用这些发现来设计量身定制的移动应用程序,以促进为MSM和其他边缘化群体提供精神保健服务和支持。
BACKGROUND: Men who have sex with men (MSM) are disproportionately burdened by poor mental health. Despite the increasing burden, evidence-based interventions for MSM are largely nonexistent in Nepal.
OBJECTIVE: This study explored mental health concerns, contributing factors, barriers to mental health care and support, and preferred interventions to improve access to and use of mental health support services among MSM in Nepal.
METHODS: We conducted focus groups with MSM in Kathmandu, Nepal, in January 2023. In total, 28 participants took part in 5 focus group sessions. Participants discussed several topics related to the mental health issues they experienced, factors contributing to these issues, and their suggestions for potential interventions to address existing barriers. The discussions were recorded, transcribed, and analyzed using Dedoose (version 9.0.54; SocioCultural Research Consultants, LLC) software for thematic analysis.
RESULTS: Participants reported substantial mental health problems, including anxiety, depression, suicidal ideation, and behaviors. Contributing factors included family rejection, isolation, bullying, stigma, discrimination, and fear of HIV and other sexually transmitted infections. Barriers to accessing services included cost, lack of lesbian, gay, bisexual, transgender, intersex, queer, and asexual (LGBTIQA+)-friendly providers, and the stigma associated with mental health and sexuality. Participants suggested a smartphone app with features such as a mental health screening tool, digital consultation, helpline number, directory of LGBTIQA+-friendly providers, mental health resources, and a discussion forum for peer support as potential solutions. Participants emphasized the importance of privacy and confidentiality to ensure mobile apps are safe and accessible.
CONCLUSIONS: The findings of this study have potential transferability to other low-resource settings facing similar challenges. Intervention developers can use these findings to design tailored mobile apps to facilitate mental health care delivery and support for MSM and other marginalized groups.