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Objective Explanatory models (EMs) are a collection of beliefs about a disorder that can help us understand help-seeking and treatment pathways in diverse contexts. In 2 related studies, we explore EMs about depression held among both clinical and nonclinical samples in Uganda. To explore the potential of EMs to predict help seeking, we assessed the relationship between 2 main aspects of the EM: problem conceptualization and treatment. Method In Study 1, we interviewed and assessed EMs of depression for 135 lay community members and 111 professional practitioners using a vignette. In Study 2, we assessed actual EMs among 33 clinically depressed adults. We transcribed all interviews and analyzed and coded the content. In Study 1, we used logistic regression to examine the relationship of problem conceptualization and stigma to treatment choice; in Study 2, we used Fisher's exact tests to examine the relationship between conceptualization and treatment. Sociodemographics such as age, income, and language were also examined. Results Interviews elicited a diverse range of beliefs about the nature of depression and the types of treatment needed. However, problem conceptualization did not predict treatment in either group. Instead, education and interview language predicted treatment in clinical and nonclinical samples. Conclusion Although EMs can be useful for both exploring mental health and treatment-related beliefs in clinical settings and developing mental health services, contextual factors may be more significant predictors of help seeking. [ABSTRACT FROM AUTHOR]

In Uganda, depression is a growing concern, yet mental health professionals are in short supply, and help is often sought from traditional healers. To develop an integrated system of care, we must understand sociocultural aspects of depression including beliefs about help seeking and treatment. In a mixed methods study, we used semi-structured interviews and self-report measures to assess depressed patients (N = 30) seeking treatment in traditional healing (n = 15) and psychiatry clinics (n = 15) near Kampala, Uganda. We assessed demographics, symptoms, treatment characteristics, and explanatory models (EMs) of depression (e.g., labeling the problem, cause, impact on life, best type of treatment). We predicted differences across treatment settings. To further explore EMs, we assessed differences in EMs of patients and their providers by interviewing patient-provider dyads (n = 8 dyads). Patients in both settings were similar in demographics, symptoms, perceived cause, seriousness, and impact of depression. However, patients at traditional clinics were more likely to desire herbal remedies, while those in psychiatry clinics were more likely to desire modern medication. Patient-provider dyads also had different treatment beliefs, with patients desiring financial assistance, social support, and medication, and providers more likely to suggest counseling or advice. The study highlights the need to understand diverse beliefs and treatment trajectories in a multicultural context. [ABSTRACT FROM AUTHOR]