Men are less likely to seek care for mental health problems both domestically and abroad. This treatment gap is widened in low- and middle-income (LMI) countries, where poor healthcare infrastructure, cultural barriers, and stigma impact treatment seeking. The gap for men between mental health needs and receipt of services is especially wide. Beyond the individual burden of symptoms, psychological distress among men has been linked to increased likelihood of poverty, alcohol abuse, and gender-based violence – concerns with negative ramifications at familial and societal levels, particularly for vulnerable populations. Research in LMI countries has demonstrated the effectiveness of contextually- and culturally-adapted psychotherapies at decreasing symptoms of common mental disorders. However, many of these trials have reported difficulties in recruiting and retaining men in therapy, limiting the evidence base for these programs. To improve the likelihood of successful engagement of men in therapy, it is necessary to identify factors that influence treatment adherence, and better understand men’s attitudes surrounding decisions to seek and initiate care. To date, there have been no studies exploring the relationship between individual factors, treatment characteristics, and men’s adherence to mental health treatment in LMI countries. The applicant proposes a preliminary investigation into factors that influence men’s engagement with psychotherapy. This research seeks to develop a conceptual model describing care initiation through interviews with men and mental health care providers in Yangon, Myanmar. The experience will be instrumental training for a career in the development and implementation of patient-focused interventions for men in domestic and international settings.

PI Mentor: Judith K. Bass