An exploration into the psychological impact of leprosy in Sirajganj, Bangladesh

Objectives: Leprosy is a neglected tropical disease still prevalent in the world today. In addition to dealing with the physical complications associated with the condition, people affected by leprosy often also face poor mental health. This study sets out to explore the psychological impact of leprosy by looking at experiences of mental health, and perceptions of the disease and disability, in a community in Bangladesh. Methods: Mixed methods including PHQ-9 and GAD-7 questionnaires and semistructured interviews (SSI) were used. 30 adult participants were recruited through systematic sampling, with a purposive approach taken to select a sub-group of 6 for a focus group discussion (FGD), prioritising those who recorded severe markers of anxiety, depression and disability level during the SSI/questionnaire. Results: 53% of participants experienced moderate to severe depression and 44% mild depression. 37% experienced severe anxiety and 37% moderate anxiety. Underlying issues for poor mental health included high levels of disability, being a woman, low educational levels, and economic dependence. Participants identified ways to recover from mental distress such as engaging with non-affected people, increased public awareness, strengthened education and restoring their ability to financially sustain themselves. Conclusion: These findings add to the growing body of literature that evidences the high mental distress associated with leprosy. Despite anxiety, depression and suicidal ideation being common challenges people with leprosy experience, leprosy treatment rarely includes provision for mental health care.