MENTAL HEALTH IN UNIVERSITY STUDENTS IN BANGLADESH: AN EXAMINATION OF CURRENT PRACTICES, SERVICE USE, AND AN EXPLORATION OF THE ACCEPTABILITY OF MHEALTH FOR MENTAL HEALTH AND MINDFULNESS

The prevalence of mental health problems, such as depression and suicide, is high in Bangladesh. The incidence of mental health problems in Bangladesh is highest in young adulthood and often occurs in university students. Mobile health apps are effective in Bangladesh for chronic health problems, though there is no current literature on the use of mHealth for mental health promotion in Bangladesh, nor in the university student population in Bangladesh. The study utilizes a multi-method design informed by Self-Determination Theory and the Technology Acceptance Model to explore motivational factors for mental health practices, such as coping techniques, and use of professional services, such as therapy. The quantitative component includes regression analysis of an online survey delivered to students currently enrolled in universities in Bangladesh to determine current attitudes and practices of mental health services (n=350) and the possibility of using mHealth for mental health (n=311). The qualitative component involves thematic analysis of semi-structured interviews with randomly selected students (n=12) who complete the quantitative portion of the study, regarding their opinion of mHealth for mental health app content. Results show that subjective perception of needing mental health support was the strongest predictor of clinical service utilization. Additionally, the perception of viewing mental health positively was associated with actual use of clinical services, but the association became insignificant after adjusting for the perceived need. One's social influences predicted perceived need for mental health support; and knowledge about mental health predicted positive views of clinical mental health care. Intent to use general mHealth is driven by social influence, ease of use, and perceived utility. According to this study, mobile health services are acceptable to this population and can be helpful for students with barriers to accessing traditional mental health services. The qualitative interviews revealed that students felt that guided mindfulness exercises relieved stress, and the potential of having easy access to such exercises on an app on their phone overcame barriers they had previously encountered. These findings suggest that an app with mindfulness exercises may be worth developing and testing in Bangladesh in order to promote student mental health