Beyond belief: understanding contexts for help-seeking for severe mental illness in urban slum communities in Dhaka, Bangladesh and Ibadan, Nigeria
Bibliographic record
Abstract
Research on help-seeking for serious mental illness (SMI) has often focused on the influence of cultural beliefs and explanatory models however a number of factors also influence decisions around treatment including availability, cost and quality of care. This study utilises an ecological framework to explore influences on help-seeking for serious mental illness in deprived urban slum communities in Ibadan, Nigeria and Dhaka, Bangladesh. Interviews and observation were conducted with family caregivers and people with lived experience of SMI. Although in both settings some participants speculated on the role of spiritual agents they also expressed uncertainty around the causes of SMI. Families commonly sought help from both biomedical practitioners and traditional and faith healers Help-seeking was embedded within complex ecologies of care, informed by considerations of quality, efficacy and cost, as much as beliefs. The complexity of influences on help-seeking and dissatisfaction with health services as well as healers suggests that a contextually informed, multi-component approach is needed which addresses health system weaknesses and affordability as well as accessibility.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".