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Background <p>Discontinuation of mental health care is a persistent global challenge, with up to one-third of patients dropping out before treatment completion. Evidence on discontinuation from facility-based tele-mental health services in low- and middle-income countries remains limited. This study explores why patients disengage from facility-based tele-mental health services delivered through Wellbeing Centres in Bangladesh.</p> Method <p>A qualitative study was conducted between October 2024 and February 2025 using mobile phone interviews. Participants were service recipients who had discontinued follow-up services provided by the Wellbeing Centres. A total of 26 interviews were conducted, and the data were analyzed thematically.</p> Results <p>Discontinuation was shaped by dynamic and sometimes contradictory patient experiences. First, perceptions of treatment outcomes influenced disengagement in complex ways: both perceived improvement and perceived lack of benefit led to discontinuation, reflecting shifting expectations of care. Second, everyday constraints—including fluctuations in mental wellbeing, competing life demands, distance from facilities, and communication gaps with providers—disrupted continuity of care. Third, family dynamics played a critical role, with limited support and motivation reducing sustained engagement with services.</p> Conclusion <p>Discontinuation from facility-based tele-mental health services is not solely driven by access barriers but emerges from the interaction between perceived recovery, unmet expectations, and socio-cultural influences, particularly family involvement. Interventions should move beyond access-focused models to incorporate continuous patient engagement, clearer communication of treatment pathways, and active involvement of family members. These findings have implications for the design and scale-up of facility-based tele-mental health services in low- and middle- income countries (LMICs).</p>

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“Now they just say it will get better on its own.”: a qualitative exploration of discontinuation of facility-based tele-mental health services in Bangladesh

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月18日

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  • Ishrat Jabeen,
  • Mohammad Sohel Shomik,
  • Sahadat Hossain,
  • Tasnu Ara,
  • Ridwana Maher Manna,
  • S. M. Hasibul Islam,
  • Tahmina Akter,
  • Nasimul Ghani Usmani,
  • Pradip Chandra,
  • Bibek Ahamed,
  • Md. Abdullah Al Mamun,
  • Md. Shariful Islam,
  • Md. Robed Amin,
  • Mohammad Muntasir Maruf,
  • Shams El Arifeen,
  • Ahmed Ehsanur Rahman,
  • Aniqa Tasnim Hossain,
  • Janet E. Perkins

摘要

Background

Discontinuation of mental health care is a persistent global challenge, with up to one-third of patients dropping out before treatment completion. Evidence on discontinuation from facility-based tele-mental health services in low- and middle-income countries remains limited. This study explores why patients disengage from facility-based tele-mental health services delivered through Wellbeing Centres in Bangladesh.

Method

A qualitative study was conducted between October 2024 and February 2025 using mobile phone interviews. Participants were service recipients who had discontinued follow-up services provided by the Wellbeing Centres. A total of 26 interviews were conducted, and the data were analyzed thematically.

Results

Discontinuation was shaped by dynamic and sometimes contradictory patient experiences. First, perceptions of treatment outcomes influenced disengagement in complex ways: both perceived improvement and perceived lack of benefit led to discontinuation, reflecting shifting expectations of care. Second, everyday constraints—including fluctuations in mental wellbeing, competing life demands, distance from facilities, and communication gaps with providers—disrupted continuity of care. Third, family dynamics played a critical role, with limited support and motivation reducing sustained engagement with services.

Conclusion

Discontinuation from facility-based tele-mental health services is not solely driven by access barriers but emerges from the interaction between perceived recovery, unmet expectations, and socio-cultural influences, particularly family involvement. Interventions should move beyond access-focused models to incorporate continuous patient engagement, clearer communication of treatment pathways, and active involvement of family members. These findings have implications for the design and scale-up of facility-based tele-mental health services in low- and middle- income countries (LMICs).