Mental disorders, particularly depression and post-traumatic stress disorder, are common long-term psychological outcomes in emergency contexts arising from conflicts, natural disasters, and other challenging environmental conditions. In emergencies, people suffer not only from the lack of external resources such as drinking water and food but also from poor mental health. Mental disorders can substantially impair daily activities in vulnerable individuals. However, water, sanitation, and hygiene (WASH) behaviors are daily activities that require effort, time, and strong internal motivation. Therefore, questions arise: whether there is a relationship between mental health and safe water behaviors, and if so, whether the motivational drivers of these behaviors are affected by mental health. Our cross-sectional study conducted face-to-face interviews with 638 households in rural Malawi. We used a quantitative questionnaire based on the risks, attitudes, norms, abilities, and self-regulation (RANAS) approach to measure motivational psychosocial factors. Mental health was assessed using the validated Chichewa version of the Self-Reporting Questionnaire (SRQ-20). Results. Almost a third of the respondents reported poor mental health. We found significant negative association between mental health and self-reported safe water collection (p = .01, r = −.104) but not between safe water transportation and storage behavior. The moderation analysis revealed significant interaction effects of mental health with some psychosocial factors and therefore on WASH behaviors. Poor mental health changed the influence of three psychosocial factors—perceived others’ behavior, commitment, and remembering—on safe drinking water collection behavior. The influence on water transportation and storage behavior of the perceived severity of contracting a disease, the belief that transporting and storing water requires substantial effort, and others’ approval depended on the mental health condition of the respondent. These results imply that populations with a significant proportion of individuals with poor mental health will benefit from interventions to mitigate mental health before or parallel to behavioral change interventions for WASH. Specific population-level interventions have been shown to have a positive effect on mental well-being, and they have been successfully applied at scale. This research is especially relevant in emergency contexts, as it indicates that mental health measures before any WASH interventions will make them more effective.

中文翻译：

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马拉维农村弱势人群的心理健康与安全饮水行为之间的联系

精神障碍，尤其是抑郁症和创伤后应激障碍，是冲突，自然灾害和其他挑战性环境条件引起的紧急情况下的常见长期心理后果。在紧急情况下，人们不仅遭受缺乏诸如饮用水和食物之类的外部资源的困扰，而且还遭受心理健康状况的恶化。精神障碍会严重损害弱势人群的日常活动。但是，水，卫生和个人卫生（WASH）行为是日常活动，需要努力，时间和强烈的内在动力。因此，出现了以下问题：心理健康与安全饮水行为之间是否存在关系，如果存在，那么这些行为的动机是否会受到心理健康的影响。我们的横断面研究对马拉维农村地区的638户家庭进行了面对面的采访。我们根据风险，态度，规范，能力和自我调节（RANAS）方法使用了定量问卷，以测量动机的社会心理因素。使用经过验证的Chichewa版本的自我报告调查表（SRQ-20）评估心理健康。结果。几乎三分之一的受访者表示心理健康状况不佳。我们发现心理健康与自我报告的安全饮水量之间存在显着的负相关性（p = .01，r = −.104），而在安全饮水的输送和储存行为之间却没有。适度分析揭示了心理健康与一些社会心理因素的显着相互作用，因此对WASH行为产生影响。不良的心理健康改变了三个社会心理因素（感知他人的行为，承诺和记忆）对安全饮水行为的影响。感觉到的患病严重程度对水运输和存储行为的影响，认为运输和存储水需要大量努力的信念以及其他人的认可取决于受访者的心理健康状况。这些结果表明，心理健康状况差的人中有很大比例的人群将在WASH的行为改变干预之前或与此同时受益于减轻心理健康的干预措施。特定人群水平的干预措施已显示出对心理健康的积极影响，并已成功地大规模应用。