Living with depression and diabetes: A qualitative study in Bangladesh and Pakistan

Hannah Maria Jennings; Ashraful Anas; Sara Asmat; Anum Naz; Saima Afaq; Naveed Ahmed; Faiza Aslam; Gerardo Zavala Gomez; Najma Siddiqi; David Ekers

doi:10.1371/journal.pgph.0002846

Living with depression and diabetes: A qualitative study in Bangladesh and Pakistan

Hannah Maria Jennings, Ashraful Anas, Sara Asmat, Anum Naz, Saima Afaq, Naveed Ahmed, Faiza Aslam, Gerardo Zavala Gomez, Najma Siddiqi, David Ekers

Research output: Contribution to journal › Article › peer-review

Abstract

Diabetes and depression are both serious health conditions. While their relationship is bidirectional and each condition adversely affects outcomes for the other, they are treated separately. In low and middle income countries, such as Bangladesh and Pakistan, health systems are already stretched and the integration of diabetes and depression care is rarely a priority. Within this context through interviews with patients, healthcare workers and policy makers the study explored: lived experiences of people living with depression and diabetes, current practice in mental health and diabetes care and barriers and perspectives on integrating a brief psychological therapy into diabetes care. The findings of the study included: differing patient and practitioner understandings of distress/depression, high levels of stigma for mental health and a lack of awareness and training on treating depression. While it was apparent there is a need for more holistic care and the concept of a brief psychological intervention appeared acceptable to participants, many logistical barriers to integrating a mental health intervention into diabetes care were identified. The study highlights the importance of context and of recognising drivers and understandings of distress when planning for more integrated mental and physical health services, and specifically when adapting and implementing a new intervention into existing services.

Original language	English
Article number	e0002846
Number of pages	19
Journal	PLOS Global Public Health
Volume	4
Issue number	1
DOIs	https://doi.org/10.1371/journal.pgph.0002846 https://doi.org/10.1371/journal.pgph.0002846
Publication status	Published - 25 Jan 2024

Bibliographical note

Keywords

Diadem

Access to Document

Living with depression and diabetes: A qualitative study in Bangladesh and Pakistan
© 2024 Jennings et al.
Final published version, 403 KBLicence: CC BY

Cite this

@article{19f9019d90c346158abbb72348985c0c,

title = "Living with depression and diabetes: A qualitative study in Bangladesh and Pakistan",

abstract = "Diabetes and depression are both serious health conditions. While their relationship is bidirectional and each condition adversely affects outcomes for the other, they are treated separately. In low and middle income countries, such as Bangladesh and Pakistan, health systems are already stretched and the integration of diabetes and depression care is rarely a priority. Within this context through interviews with patients, healthcare workers and policy makers the study explored: lived experiences of people living with depression and diabetes, current practice in mental health and diabetes care and barriers and perspectives on integrating a brief psychological therapy into diabetes care. The findings of the study included: differing patient and practitioner understandings of distress/depression, high levels of stigma for mental health and a lack of awareness and training on treating depression. While it was apparent there is a need for more holistic care and the concept of a brief psychological intervention appeared acceptable to participants, many logistical barriers to integrating a mental health intervention into diabetes care were identified. The study highlights the importance of context and of recognising drivers and understandings of distress when planning for more integrated mental and physical health services, and specifically when adapting and implementing a new intervention into existing services.",

keywords = "Diadem",

author = "Jennings, {Hannah Maria} and Ashraful Anas and Sara Asmat and Anum Naz and Saima Afaq and Naveed Ahmed and Faiza Aslam and Gomez, {Gerardo Zavala} and Najma Siddiqi and David Ekers",

note = "{\textcopyright} 2024 Jennings et al.",

year = "2024",

month = jan,

day = "25",

doi = "10.1371/journal.pgph.0002846",

language = "English",

volume = "4",

journal = "PLOS Global Public Health",

issn = "2767-3375",

number = "1",

}

TY - JOUR

T1 - Living with depression and diabetes

T2 - A qualitative study in Bangladesh and Pakistan

AU - Jennings, Hannah Maria

AU - Anas, Ashraful

AU - Asmat, Sara

AU - Naz, Anum

AU - Afaq, Saima

AU - Ahmed, Naveed

AU - Aslam, Faiza

AU - Gomez, Gerardo Zavala

AU - Siddiqi, Najma

AU - Ekers, David

PY - 2024/1/25

Y1 - 2024/1/25

N2 - Diabetes and depression are both serious health conditions. While their relationship is bidirectional and each condition adversely affects outcomes for the other, they are treated separately. In low and middle income countries, such as Bangladesh and Pakistan, health systems are already stretched and the integration of diabetes and depression care is rarely a priority. Within this context through interviews with patients, healthcare workers and policy makers the study explored: lived experiences of people living with depression and diabetes, current practice in mental health and diabetes care and barriers and perspectives on integrating a brief psychological therapy into diabetes care. The findings of the study included: differing patient and practitioner understandings of distress/depression, high levels of stigma for mental health and a lack of awareness and training on treating depression. While it was apparent there is a need for more holistic care and the concept of a brief psychological intervention appeared acceptable to participants, many logistical barriers to integrating a mental health intervention into diabetes care were identified. The study highlights the importance of context and of recognising drivers and understandings of distress when planning for more integrated mental and physical health services, and specifically when adapting and implementing a new intervention into existing services.

AB - Diabetes and depression are both serious health conditions. While their relationship is bidirectional and each condition adversely affects outcomes for the other, they are treated separately. In low and middle income countries, such as Bangladesh and Pakistan, health systems are already stretched and the integration of diabetes and depression care is rarely a priority. Within this context through interviews with patients, healthcare workers and policy makers the study explored: lived experiences of people living with depression and diabetes, current practice in mental health and diabetes care and barriers and perspectives on integrating a brief psychological therapy into diabetes care. The findings of the study included: differing patient and practitioner understandings of distress/depression, high levels of stigma for mental health and a lack of awareness and training on treating depression. While it was apparent there is a need for more holistic care and the concept of a brief psychological intervention appeared acceptable to participants, many logistical barriers to integrating a mental health intervention into diabetes care were identified. The study highlights the importance of context and of recognising drivers and understandings of distress when planning for more integrated mental and physical health services, and specifically when adapting and implementing a new intervention into existing services.

KW - Diadem

U2 - 10.1371/journal.pgph.0002846

DO - 10.1371/journal.pgph.0002846

M3 - Article

C2 - 38271347

SN - 2767-3375

VL - 4

JO - PLOS Global Public Health

JF - PLOS Global Public Health

IS - 1

M1 - e0002846

ER -