Depression and Its Help Seeking Behaviors: A Systematic Review and Meta-Analysis of Community Survey in Ethiopia

Abstract

Background Depression is one of the most common mental illnesses affecting around 322 million individual in the world. Although the prevalence of depression is high and its treatment is effective, little is known about its pooled prevalence and help seeking behaviors in the community settings of Ethiopia. Thus, this study aimed to determine the pooled prevalence of depression and its help seeking behaviors in Ethiopia. Methods A systematic literature search in the databases of Pub-Med, Cochrane, and Google Scholar was performed. The quality of studies was assessed using the Newcastle-Ottawa quality assessment tool adapted for cross-sectional studies. Heterogeneity test and evidence of publication bias were assessed. Moreover, sensitivity test was also performed. Pooled prevalence of depression and its help seeking behavior were calculated using random effects model. Results A total 13 studies for depression, 4 studies for help seeking intention, and 5 studies for help seeking behaviour were included in this review. The pooled prevalence of depression and help seeking intention and behaviour was found to be 20.5% (95% CI; 16.5% -24.4%), 42% (95% CI; 23%-60%), and 38% (95% CI; 23%-52%), respectively. There is no significant heterogeneity for depression (I2 = 0%, p =0.620), help seeking intention (I2 = 0%, p =0.996), and behaviour (I2 = 0%, p =0.896). There is no publication bias for depression egger's test (p =0.689). Conclusion More than one in every five individuals were experiencing depression. Less than one-third of individuals with depression seek help from modern treatment. Authors suggest community based mental health screening and treatment.

Mental distress, perceived need and barriers to receive professional mental health care among university students

“…Our finding is higher than what has been reported in the general population of Ethiopia. In a meta-analysis of Ethiopian studies the pooled prevalence of the help-seeking intention of people with depression in Ethiopia is 42% [35] which is much lower than the current finding. The possible explanations for the difference could be difference in mental health literacy, study population and data collection instruments being used.…”

“…However, only few people receive professional mental health service. For instance, a meta-analysis reported that the pooled prevalence of formal mental health help-seeking behaviors and intention of people with depression is 38% and 48%, respectively [35]. In Ethiopia, most people with mental illness first contact non-professional care providers such as religious leaders and herbalists [36].…”

Help Seeking Preferences to Informal and Formal Source of Care for Depression: a Community Based Study in Northwest Ethiopia

“…Previous literatures showed more than one in ve of the community residents (20.5%) had depression in Ethiopia (21). We examined communities' preference to seek help for depression by presenting them a vignette depicting an individual experiencing a major depressive disorder and asking them to report their preferences to seek help from formal and/ informal sources if they were having a similar situation.…”

“…Indeed, it increases the burden of other chronic medical illnesses such as HIV/AIDS, cardiac failure, diabetes mellitus,tuberculosis and surgical illness (9,10). Its' impact on the cause of life threating illnesses is unbearable in low income countries including Ethiopia (11,12) with the estimated magnitude ranging from 2.4% to 60% (13)(14)(15)(16)(17).The other trajectory consequence of depression is suicide (8,18,19) and substance use (20,21).…”

“…This study helps to guide the effective planning and provision of mental health services and health policy of the country to explore the communities' preferences of help-seeking treatment areas. In Ethiopia, there are studies regarding formal help seeking behavior about depression from health care providers (14,16,21,45), but, there is no a community survey on formal and informal help seeking preferences. Thus, the purpose of this community survey was to assess the magnitude of formal and informal help seeking preferences for depression in northwest Ethiopia.…”