Barriers to the uptake of digital mental health interventions in low resource settings: perceptions of young people in Uganda

<b>Introduction:</b> One of the benefits of digital mental health is enhanced access to healthcare, particularly in low and middle-income countries where government investment in mental healthcare is low. However, uptake among young people is low. This study aimed to explore young people’s perceptions of the barriers to the uptake of digital mental health interventions in low-resource settings.<b>Methods:</b> A qualitative descriptive approach was used to collect data. Six face-to-face focus group discussions were conducted with 50 purposively selected young people from nine universities in Uganda. A thematic approach was used to interpret the results.<b>Results:</b> Most respondents had a positive attitude towards digital mental health and some of them had used it before. There was a preference for digital interventions that are reliable and have an option for human interaction. The perceived barriers to young people’s uptake of digital mental health included the fear of stigma, affordability, inequitable access, privacy and confidentiality concerns, and app-related challenges. Access and use of digital mental health can be enhanced through public engagement, creating awareness, enhanced training, and access to affordable DMH interventions.<b>Conclusion:</b> Digital mental health was deemed important in extending much-needed healthcare to young people, particularly in health systems where traditional mental health services are not readily available. However, several factors hinder equitable access to digital mental health in low-resource settings. There is a need for long-term investment in digital health technologies aimed at tackling structural barriers that generate health disparities.

<b>引言:</b> 数字化心理健康（digital mental health）的优势之一在于提升了医疗服务可及性，尤其在政府精神卫生医疗投入不足的中低收入国家。然而，青年人群对其采用率仍偏低。本研究旨在探究资源匮乏环境下，青年群体采用数字化心理健康干预手段的感知障碍。<b>方法:</b> 本研究采用定性描述性研究方法（qualitative descriptive approach）收集数据。研究人员招募了来自乌干达9所大学、经目的性抽样选取的50名青年，开展了6次面对面焦点小组讨论（focus group discussions），并通过主题分析法（thematic approach）对研究结果进行解读。<b>结果:</b> 多数受访者对数字化心理健康持积极态度，部分受访者曾使用过相关服务。研究对象更青睐具备可靠性且支持人际互动选项的数字化干预手段。青年群体采用数字化心理健康服务的感知障碍包括：污名化恐惧、可负担性不足、获取渠道不公、隐私与保密顾虑，以及应用程序相关问题。可通过公众参与、认知普及、强化培训以及提供可负担的数字化心理健康干预手段，提升数字化心理健康服务的可及性与使用率。<b>结论:</b> 数字化心理健康被认为可为青年群体提供亟需的医疗服务，尤其在传统精神卫生服务难以获取的医疗体系中。然而，在资源匮乏环境下，多项因素阻碍了数字化心理健康服务的公平可及。未来需对数字健康技术进行长期投入，以破解导致健康不平等（health disparities）的结构性障碍。