Who gets help? Analyzing disparities in diagnosis, treatment, and care seeking of anxiety and depression among women in Bangladesh

Reproductive-aged women in Bangladesh exhibit low rates of anxiety and depression diagnosis, treatment, and care-seeking. This study investigated these factors and their correlates. Using data from the 2022 Bangladesh Demographic and Health Survey, we analyzed diagnosis (whether a healthcare provider ever informed), treatment (prescribed medication), and care-seeking (ever sought help and source). Log-binomial and Poisson regression models identified associated factors. Overall, 7.6% of respondents reported ever being diagnosed with anxiety and/or depression. When disaggregated, 3.39% were diagnosed with anxiety only, 0.56% with depression only, and 3.62% with both conditions. Furthermore, 11.85% had sought care from the formal sector. Compared with women aged 15-19 years, those aged 25 years and above showed significantly higher prevalence of diagnosis and care-seeking, while treatment was significantly higher among women aged 40-49 years. After adjustment, regional and residence-based differences in treatment were not statistically significant; however, some divisions showed significantly higher odds of care-seeking. Women with a positive attitude towards wife beating showed higher levels of diagnosis (PR = 1.28, CI: 1.06, 1.45, p = 0.008), treatment (PR = 1.50, CI: 1.17, 1.92, p = 0.001), and care-seeking (PR = 1.52, CI: 1.34, 1.72, p < 0.001) but 37% lower formal care-seeking (PR: 0.63, 95% CI: 0.43, 0.91, p = 0.013). Middle class (PR = 1.19, CI: 1.00, 1.41, p = 0.046) and working women (PR = 1.22, CI: 1.09, 1.38, p = 0.001) had a higher care-seeking, while non-internet users (PR = 0.67, CI: 0.59, 0.77, p < 0.001) had a lower prevalence of care-seeking. Women with a bank account were 42% more likely to seek formal care (PR: 1.42, 95% CI: 1.06, 1.91, p = 0.019). Policy actions are needed to reduce mental health stigma and establish specialized departments in government hospitals. Efforts to improve mental health care utilization should focus on enhancing financial access, expanding internet use, and addressing women's attitudes that influence care-seeking behavior.