Medication adherence, depression levels, and quality of life among young people with depression in Indonesia: a mixed method study

Background: Limited information is available on medication adherence, depression levels, and quality of life (QoL) among young individuals with depression in Indonesia. Objectives: This study examined factors associated with medication adherence, depression severity, and QoL in young Indonesians with depression. It also explored (1) reasons for good or poor adherence and (2) participants' perceived QoL. Methods: A mixed-methods sequential explanatory design was employed from January to June 2022. A national cross-sectional survey of 681 participants was conducted, followed by qualitative interviews with 40 participants. Results: Low medication adherence was observed in 76.2% of participants. Higher adherence was associated with a bachelor's degree. Lower depression levels were linked to older age, female gender, longer treatment duration, and a family history of psychiatric disorders (p < 0.05). QoL significantly declined among people with higher income, the presence of family psychiatric disorders, lower adherence, and more severe depression level. Qualitative findings highlighted inadequate mental health literacy, marital status, low income, lack of support, and side effects as barriers to adherence. Financial stability and positive social support were critical for better QoL. Conclusion: Key factors influencing medication adherence among young Indonesians with depression included income, national health insurance coverage, mental health literacy, and social support. Strengthening communication between patients and mental health providers, particularly psychiatrist, is essential to optimize treatment plans and improve outcomes.