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Background <p>Frail older adults in rural Bangladesh face a high burden of unmanaged depression and anxiety due to limited access to mental health care. Tele-mental health services offer a promising alternative to address these gaps. This study explored how frail older adults cope with mental health challenges and assessed a facility-based tele-mental health intervention, including its acceptability, barriers, adoption, appropriateness, and provider insights on feasibility and sustainability.</p> Methods <p>We conducted a qualitative phenomenological study in 3 rural districts of Bangladesh. Purposive sampling was used to recruit frail older adults (≥ 60 years) with depression and anxiety, alongside psychologists and medical officers engaged in tele‑mental health counselling. Data were collected between March and June 2025 through 12 in‑depth interviews with older adults and 8 key informant interviews with service providers using semi‑structured guideline.</p> Results <p>Older adults often viewed emotional distress as part of aging and coped through prayer and daily routines. Stigma, low awareness, and practical barriers especially for women hindered access to mental health care. Those who used the tele-mental health counselling service, initially skeptical, later found it helpful and encouraged peers to attend. Providers described the service helpful for underserved older adults but identified gaps in infrastructure, awareness, and integration with the public healthcare system.</p> Conclusion <p>Participants described facility-based tele-mental health counselling as acceptable and appropriate for frail older adults, meeting their needs and preferences for privacy, empathy, and culturally familiar coping. So, improving support for this group requires reducing stigma, raising awareness, and integrating services into routine primary healthcare.</p>

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Tele-mental health for frail older adults in rural Bangladesh: a phenomenological study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月21日

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  • Ridwana Maher Manna,
  • Md Hafizur Rahman,
  • Pradip Chandra,
  • Nasimul Ghani Usmani,
  • Tamanna Majid,
  • Jesmin Mahmuda Juthi,
  • Fatema Shahrin,
  • Sadia Afrose Shams,
  • Fahmida Afroze,
  • S. M. Hasibul Islam,
  • Mohammad Sohel Shomik,
  • Anisuddin Ahmed,
  • Shams El Arifeen,
  • Ahmed Ehsanur Rahman,
  • Aniqa Tasnim Hossain

摘要

Background

Frail older adults in rural Bangladesh face a high burden of unmanaged depression and anxiety due to limited access to mental health care. Tele-mental health services offer a promising alternative to address these gaps. This study explored how frail older adults cope with mental health challenges and assessed a facility-based tele-mental health intervention, including its acceptability, barriers, adoption, appropriateness, and provider insights on feasibility and sustainability.

Methods

We conducted a qualitative phenomenological study in 3 rural districts of Bangladesh. Purposive sampling was used to recruit frail older adults (≥ 60 years) with depression and anxiety, alongside psychologists and medical officers engaged in tele‑mental health counselling. Data were collected between March and June 2025 through 12 in‑depth interviews with older adults and 8 key informant interviews with service providers using semi‑structured guideline.

Results

Older adults often viewed emotional distress as part of aging and coped through prayer and daily routines. Stigma, low awareness, and practical barriers especially for women hindered access to mental health care. Those who used the tele-mental health counselling service, initially skeptical, later found it helpful and encouraged peers to attend. Providers described the service helpful for underserved older adults but identified gaps in infrastructure, awareness, and integration with the public healthcare system.

Conclusion

Participants described facility-based tele-mental health counselling as acceptable and appropriate for frail older adults, meeting their needs and preferences for privacy, empathy, and culturally familiar coping. So, improving support for this group requires reducing stigma, raising awareness, and integrating services into routine primary healthcare.