Understanding the social determinants of mental health of undergraduate students in Bangladesh: interview study

Background: Undergraduate student population is actively studied in digital mental health research. However, the existing literature primarily focused on students from developed nations, and undergraduates from developing nations remain understudied. Objective: This study aims to identify the social determinants of mental health among undergraduate students in Bangladesh, a developing nation in South Asia. Our goal is to identify the broader social determinants of mental health among this population, study the manifestation of these determinants in their day-to-day life, and explore the feasibility of self-monitoring tools in helping them identify the specific factors or relationships that impact their mental health. Methods: We conducted a 21-day study with 38 undergraduate students from seven universities in Bangladesh. We conducted two semi-structured interviews: one pre-study and one post-study. During the 21-day study, participants used an Android application to self-report and self-monitor their mood after each phone conversation. The app prompted participants to report their mood after each phone conversation and provided graphs and charts so that participants could independently review their mood and conversation patterns. Results: Our results show that academics, family, job and economic condition, romantic relationship, and religion are the major social determinants of mental health among undergraduate students in Bangladesh. Our app helped the participants pinpoint the specific issues related to these factors as participants could review the pattern of their moods and emotions from past conversation history. Although our app does not provide any explicit recommendation, participants took certain steps on their own to improve their mental health (e.g., reduced the frequency of communication with certain persons). Conclusions: While some of the factors (e.g., academics) were reported in prior studies conducted in the Global North, this paper sheds light on some new issues (e.g., extended family problems, religion, etc.) that are specific to the context of the Global South. Overall, the findings from this study would provide better insights for the researchers to design better solutions to help the younger population from this part of the world.