Abstract
BackgroundMental health problems among young peoples are a growing public health issue around the world. In low- income countries health systems are characterized by lack of facilities, human resources and primary health care is rarely an integrated part of overall health care services. This study aims at exploring how primary health care professionals in Nicaragua perceive young people’s mental health problems, suicidal problems and help–seeking behaviour.MethodsTwelve in-depth interviews were conducted with nurses and doctors working in primary health care services in León, Nicaragua. A qualitative research design was applied. Data was analysed using thematic analysis approach.ResultsThis study revealed that doctors and nurses were reluctant to deal with young people presenting with suicidal problems at the primary health care. This was more likely to stem from feelings of incompetence rather than from negative attitudes. Other barriers in providing appropriate care to young people with mental health problems were identified such as lack of time, lack of privacy, lack of human resources, lack of trained professionals and difficulties in communicating with young people. The primary health care (PHC) professionals suggested different solutions to improve care for young people with suicidal problems.ConclusionPHC doctors and nurses in Nicaragua felt that providing skilled mental health services to young people was a priority for them but they also identified a number of barriers to be able to do so. They discussed ways to improve young people’s willingness to share sensitive issues with them and suggested ways to make PHC more appreciated by young people.
Highlights
Mental health problems among young peoples are a growing public health issue around the world
“Building trust takes time” In general, doctors and nurses perceived that young people mainly come to primary health care seeking help with issues linked to reproductive health, such as problems related to contraceptive use or pregnancy
All informants mentioned trust as a key aspect in their everyday work with their patients, and emphasised that trust is a key issue for all actors involved,: the community, the primary health care centre and young people attending the centre Several informants commented that age difference between themselves and their young patients had very little to do with building a positive relationship with young patients
Summary
Mental health problems among young peoples are a growing public health issue around the world. In low- income countries health systems are characterized by lack of facilities, human resources and primary health care is rarely an integrated part of overall health care services. This study aims at exploring how primary health care professionals in Nicaragua perceive young people’s mental health problems, suicidal problems and help–seeking behaviour. A primary health care (PHC) system well integrated in the community and accessible to all individuals has a key role to play in promoting mental health and the treatment of common mental disorders [3]. Suicide victims and attempters are likely to have attended health care services presenting with other health problems prior to their suicidal act. Counselling skills can help health care professionals identify those at risk [4] For those high-risk individuals who present with overt suicidal behaviour, proper management is crucial
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