Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: April 2, 2025

Background: Depression remains a critical mental health challenge among young people in low-resource settings, where financial, structural, and social barriers frequently limit care access. Digital approaches, including tele-support psychotherapy (TSP), have emerged as promising, scalable alternatives to standard in-person services (SMHS); however, comparative insights into their relative strengths limitations remain scarce. Objective: This study sought identify compare facilitators influencing youth engagement with TSP versus SMHS for depression treatment Kampala District, Uganda. Methods: We conducted qualitative phenomenological investigation involving aged 15–30 enrolled randomized controlled trial evaluating both interventions. Data were gathered through semi-structured key informant interviews focus groups participants lay counselors, analyzed via inductive thematic analysis Results: Among 154 assigned TSP, 95 engaged the tele-psychotherapy call platform, compared only 15 out of 146 group. disparity underscores potential improve access care. Key interventions included strong support networks higher income levels, highlighting crucial interplay individual systemic factors. Technological challenges, such unreliable communication, hindered while high costs limited awareness SMHS. Government policies played dual role, fostering trust digital inadvertently limiting some. Lay counselor attributes, flexibility rapport-building skills, facilitators. Conclusion: presents viable alternative SMHS, particularly facing financial logistical barriers. However, optimizing its delivery requires addressing technological constraints, ensuring consistent government support, integrating literacy initiatives. Findings underscore need flexible contextually tailored models that leverage technology address enhance service resource-constrained settings.

Language: Английский