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Background <p>Mental health disorders pose a critical burden globally, 400&#xa0;million incident and 1.1&#xa0;billion prevalent cases; and in Bangladesh, 10.38&#xa0;million incident and 24.05&#xa0;million prevalent cases in 2023. Despite the mental health burden in Bangladesh, the majority of the people (&gt; 90%) do not receive required services, due to the concentration of service providers in big cities, leaving rural and marginalized people disproportionately affected. Therefore, to address these barriers, the Non-Communicable Disease Control (NCDC) programme established tele-mental health services in government facilitated Wellbeing Centers at district and sub-district level. Thus, our study aimed to assess early implementation outcomes of the Wellbeing Center model.</p> Methods <p>The Wellbeing Centers implementation model was established in January 2023 in two district and five sub-district level hospitals to provide mental health services. We measured WHO’s implementation research outcomes comparing with preset benchmark. Data were collected using a structured questionnaire from healthcare providers (<i>n</i> = 167) and service recipient (<i>n</i> = 7825).</p> Results <p>The findings revealed that the majority of the service providers perceived (96.4%, 95% CI: 92.3–98.6) the Wellbeing Centers fit well with the existing infrastructure of their facility. Whereas, half of the service providers (49.7%, 95% CI: 41.8–57.5) highlighted the shortages of staff in implementation. Besides, 99.8% (95% CI: 99.6–99.8) of user participants perceived that the WBC improved their access to mental health services, mental health services from WBC were acceptable (99.8%, 95% CI: 99.6–99.8), and the WBC was useful (99.9%, 95% CI: 99.7–99.9). Moreover, high prevalence of moderate to severe anxiety (85.1%, 95% CI: 84.1–85.8) and depression (84.3%, 95% CI: 83.4–85.1) highlights a clear requirement for mental health care among participants. Multiple logistic regression identified several determinants of accessibility (high income group had 24% higher access), acceptability (unmarried had 35% lower acceptability), and usefulness (people aged higher than 50 years had 22% lower usefulness) of the Wellbeing Centers.</p> Conclusion <p>This implementation study indicated high initial service uptake, feasibility, accessibility, acceptability, and usefulness of Wellbeing Center in addressing mental health challenges in low-resource settings like Bangladesh. Acknowledging human resource shortages, retention barriers, staff training, and infrastructural resilience will be required to scaling up the intervention.</p> Clinical trial number <p>Not applicable.</p>

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Early feasibility of telemedicine-based mental health wellbeing centers: an implementation study in district and sub-district health facilities in Bangladesh

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月6日

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  • Mohammad Sohel Shomik,
  • Aniqa Tasnim Hossain,
  • Sahadat Hossain,
  • Md Hafizur Rahman,
  • Ridwana Maher Manna,
  • SM Hasibul Islam,
  • Tasnu Ara,
  • Md Abdullah Al Mamun,
  • Md Shariful Islam,
  • Ishrat Jabeen,
  • Jesmin Mahmuda Juthi,
  • Fatema Shahrin,
  • Sadia Afrose Shams,
  • Fahmida Afroze,
  • Nasimul Ghani Usmani,
  • Zahiduzzaman Sakil,
  • Bibek Ahamed,
  • Maruf Ahmed Khan,
  • SM Mustafizur Rahman,
  • Helal Uddin Ahmed,
  • Muntasir Maruf,
  • Pradip Chandra,
  • Shafiqul Ameen,
  • Anisuddin Ahmed,
  • Mohammad Robed Amin,
  • Shams El Arifeen,
  • Ahmed Ehsanur Rahman

摘要

Background

Mental health disorders pose a critical burden globally, 400 million incident and 1.1 billion prevalent cases; and in Bangladesh, 10.38 million incident and 24.05 million prevalent cases in 2023. Despite the mental health burden in Bangladesh, the majority of the people (> 90%) do not receive required services, due to the concentration of service providers in big cities, leaving rural and marginalized people disproportionately affected. Therefore, to address these barriers, the Non-Communicable Disease Control (NCDC) programme established tele-mental health services in government facilitated Wellbeing Centers at district and sub-district level. Thus, our study aimed to assess early implementation outcomes of the Wellbeing Center model.

Methods

The Wellbeing Centers implementation model was established in January 2023 in two district and five sub-district level hospitals to provide mental health services. We measured WHO’s implementation research outcomes comparing with preset benchmark. Data were collected using a structured questionnaire from healthcare providers (n = 167) and service recipient (n = 7825).

Results

The findings revealed that the majority of the service providers perceived (96.4%, 95% CI: 92.3–98.6) the Wellbeing Centers fit well with the existing infrastructure of their facility. Whereas, half of the service providers (49.7%, 95% CI: 41.8–57.5) highlighted the shortages of staff in implementation. Besides, 99.8% (95% CI: 99.6–99.8) of user participants perceived that the WBC improved their access to mental health services, mental health services from WBC were acceptable (99.8%, 95% CI: 99.6–99.8), and the WBC was useful (99.9%, 95% CI: 99.7–99.9). Moreover, high prevalence of moderate to severe anxiety (85.1%, 95% CI: 84.1–85.8) and depression (84.3%, 95% CI: 83.4–85.1) highlights a clear requirement for mental health care among participants. Multiple logistic regression identified several determinants of accessibility (high income group had 24% higher access), acceptability (unmarried had 35% lower acceptability), and usefulness (people aged higher than 50 years had 22% lower usefulness) of the Wellbeing Centers.

Conclusion

This implementation study indicated high initial service uptake, feasibility, accessibility, acceptability, and usefulness of Wellbeing Center in addressing mental health challenges in low-resource settings like Bangladesh. Acknowledging human resource shortages, retention barriers, staff training, and infrastructural resilience will be required to scaling up the intervention.

Clinical trial number

Not applicable.