Association between women's empowerment and mental health help-seeking behaviour in Bangladesh: findings from a nationally representative survey.

backgroundDespite a high disease burden, care-seeking for mental health symptoms is low in Bangladesh, particularly among women.

objectiveTo evaluate help-seeking behaviours for anxiety and depression symptoms among Bangladeshi women aged 15-49 and its association with women's empowerment.

methodsData from the Bangladesh Demographic and Health Survey 2022 including 2881 women reporting anxiety or depression symptoms were analysed. Help-seeking behaviours, sociodemographics and women's empowerment using the Survey-based Women's Empowerment (SWPER) index were assessed. Logistic regression models were used to explore associations.

resultsThe mean age of participants was 33.3 years (SD 8.7); two-thirds lived in rural areas. In the SWPER index, 83% of women had high empowerment in the attitude to violence domain, 16% in social independence and 60% in decision-making. Among women with anxiety or depression symptoms, 18.7% sought help, mainly from spouses (43%) or family (52%), and 15% consulted doctors. Women aged >30 years (adjusted OR, aOR 1.25, 95% CI 1.02 to 1.53), from rich households (aOR 1.49, 95% CI 1.09 to 1.89), and with secondary (aOR 1.47, 95% CI 1.08 to 2.01) or higher education (aOR 1.56, 95% CI 1.03 to 2.36) were more likely to seek help. High empowerment in attitude to violence (aOR 0.54, 95% CI 0.37 to 0.81) and decision-making (aOR 0.53, 95% CI 0.41 to 0.68) correlated negatively with help-seeking.

conclusionsFew Bangladeshi women seek help for mental health symptoms, relying on informal sources. Age, education, wealth and employment predict help-seeking, while high empowerment level in attitude to violence and decision-making domain of SWPER index shows an inverse relationship.