Contextually salient barriers and facilitators to implementing community-based mental health interventions delivered...

Mental health conditions represent a major global burden. However, minimally adequate treatment coverage for common mental disorders remains critically low. Task-sharing solutions using non-specialist providers are promising, but successful implementation requires understanding local culture and context. This study explored facilitators and barriers to implementing non-specialist mental health interventions in Senegal. We conducted in-depth qualitative interviews with 53 stakeholders, including social protection program facilitators, beneficiaries and community members. Data were analyzed using thematic analysis. Four primary themes were constructed: (1) implementation barriers, (2) facilitating factors, (3) health-seeking beliefs and practices and (4) community recommendations. Key barriers include strong preferences for family-based problem-solving, stigma and financial constraints. Facilitators included recognition of the therapeutic benefit of interpersonal dialogue, empathetic values towards helping those with mental health conditions and community enthusiasm for mental health interventions. Culturally adapted interventions need to navigate cultural norms and leverage existing community strengths in interpersonal support. The coexistence of stigma and empathy, alongside both resistance and openness to non-specialist services, highlights a dynamic tension that not only challenges implementation but also presents an opportunity for change. These findings contribute essential formative evidence for designing effective, sustainable non-specialist mental health interventions in Senegal and the sub-Saharan African region.