Barriers to Mental Health Treatment: Results from the WHO World Mental Health WMH Surveys PMC

This stresses the extent and relevance of this problem, and the importance for governments and institutions to address the specific organisational aspects that account for delay in their particular setting. This study found that fragmented services and the provision of limited resources were also contextual factors that constrained accessibility and utilisation of treatment services. It is evident that the government policy on making mental health services easily accessible and affordable by integrating these services into primary healthcare settings (e.g. South Africa’s 1997 White Paper Act on Health) has not been well implemented.

The number of times each specific barrier was mentioned in either the results section or a data table within each review was recorded. A variety of barriers to major depressive disorder treatment prevent the best patient outcomes, including systemic as well as patient-specific factors. Although the strength of our included study designs was limited due to their qualitative nature, this systematic review highlights the need for devoting more attention to this poorly studied subject matter.

Similar statistics prevail in other African countries, suggesting that monetary and political investments are needed to improve the state of economic barriers that often deter patients from seeking adequate care (Docrat et al., 2019). However, the majority of these studies is from the Anglosphere, (i.e. the United States , United Kingdom and Canada) , limiting ecological validity for European countries. This makes it interesting to investigate whether previously identified factors are also relevant in a high-access setting where costs for health care are barely an issue , and whether unique factors play a role. Qualitative research offers the opportunity to gain rich in-depth information and hence promotes understanding of complex topics, leading to deepening insight on factors influencing treatment-seeking. Therefore, the aim of this study was to examine both barriers and facilitating factors of treatment-seeking in patients with anxiety or depressive disorders in a Western-European healthcare setting, using qualitative methods. Much effort was put in recruiting a diverse study population, resulting in a well-balanced study sample with regard to age, gender, and psychiatric history.

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Let’s look at the top five barriers to mental health care and how we can begin to surpass them. What we say and how we say it makes a difference to patients with substance use disorder. One of the best ways you can combat perceived which mental disorder is most commonly comorbid with alcoholism mental health and substance use disorder stigma is using person-first language. Multiple studies find that patient-cen- tered language that focuses on behaviors can reduce stigma and increase positive health outcomes.

Interestingly, his mother was supportive and encouraged him to seek help, thus overcoming the negative judgment from his father. Contrary to recognition, participants also reported that psychological complaints were not always visible for others, or were not understood. However, some participants with unfavourable or ambivalent experiences kept hope nonetheless. One participant who developed obsessive-compulsive disorder during pregnancy considered her psychological complaints without an understandable cause abnormal, which in combination with ridiculing statements about her symptoms from her environment made her feel ashamed. Kessler RC, Frank RG, Edlund M, Katz SJ, Lin E, Leaf P. Differences in the use of psychiatric outpatient services between the United States and Ontario.

One female refused help for as long as 10 years because of her previous negative experiences. She felt inadequately treated during a clinical medication detoxification as she was discharged from the hospital and referred to her general practitioner even though she felt in crisis. During that period, she made multiple suicide attempts and experienced serious withdrawal symptoms because of sudden tapering of medication.

Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide. Spearheading new initiatives and bolstering existing programming could augment awareness of mental illness within African countries. In order to adequately serve the different population needs, it is imperative to obtain a community needs assessment and receive input from citizens of the country. Collaboration with members of the community can facilitate buy-in by others and also improve outcomes in relation to sustainability of program impact. Increasing community awareness of the burden of mental illness within each country is designed to improve perceptions of mental illness. Seeing as certain mental illnesses such as depression present differences in prevalence among genders, it is important that programming be both inclusive and sensitive to cultural practices and individual characteristics.

Fragmented services

Stigma and negative traditional connotations of mental illness within African countries have resulted in politicians and government officials neglecting to address the illness burden within their countries. Other political agendas are prioritized, leading to a low number of political stakeholders, inefficient policies, and barriers to policy inception and implementation. The Health Action Plan was created originally to increase service quality and usage for mental, neurological, and substance use disorders in lower and middle-income countries . Despite the objectives of this action plan, Africa has unfortunately fallen behind in meeting the goals set forth by the WHO.

Consequently, we may have missed relevant barriers and facilitators to treatment-seeking in the population. Many factors exacerbate the mental illnesses that individuals face within these countries. Stigma and lack of mental illnesses knowledge are the main contributors to alcohol rehab and recovery information the plight experienced by these individuals and their surrounding support system (Mawadri, 2017; Schweitzer, 2019). Additionally, individuals with mental illnesses are marginalized, and face discrimination due to traditional beliefs that these illnesses cannot be treated.

Open access

All Part 1 respondents who met criteria for any disorder and a subsample of approximately 25% of others were administered Part 2. Part 2 respondents were weighted by the inverse of their probability of selection to adjust for differential sampling. The Part 2 sample included 63,678 respondents, including 32,387 from high-income, 15,240 from upper-middle, and 16,051 from low/lower-middle income countries. Because questions regarding reasons for not using services and drop-out were usually asked in Part II, the present analyses are limited to this subsample. Even if the four previous mentioned barriers could be prevented, individuals experiencing a mental health crisis may be wait listed before they can get access to a mental health provider.

In the event that the reviewer was unable to determine eligibility based on title and abstract, the full-text article was reviewed in duplicate and independently by two blinded reviewers. The theme of culture, which became one of the central themes in this study, had only a few questions/items in the quantitative phase of the study. This was largely because culture as a theme did not emerge prominently in the FGDs which were meant to be used to adapt the questionnaire, but emerged more prominently in the SSIs after the questionnaire had already been adapted and administered. The original 50-item questionnaire itself was not sensitive enough to the cultural aspects of the South African context because the questionnaire was not developed nor used locally, it had mostly been used in countries such as Mexico . Yes, religion can sometimes block us from getting help, because people believe that church is one of the first things that is needed for a person to be treated; prayer and attending church.

• Alonso J, Codony M, Kovess V, Angermeyer MC, Katz SJ, Haro JM, De Girolamo G, De Graaf R, Demyttenaere K, Vilagut G, Almansa J, Lepine JP, Brugha TS. Population level of unmet need for mental healthcare in Europe.
• In developing countries there is a gap between policy and financing (Saxena et al., 2003) with under provision and inefficiency in use of resources (Andrade et al., 2008; Seedat et al., 2008).
• There are approximately 1,000 patients for every 1 provider, and the US needs to add approximately 10,000 providers by 2025 in order to make pace with the growing demand for services.
• He has a doctorate degree in clinical psychology from the University of Massachusetts, Boston and spent 16 years as a psychologist with the U.S.
• Instead, we used the findings from the CASP checklist to provide general commentary on the overall strength and quality of our findings.
• They need help evaluating their treatment options and need someone to support their courageous decision.

Luckily, the American Psychological Association is seeing more people of color earning psychology degrees, a trend that is en­hancing the diversity of the psychology workforce and will help break down barriers to more equitable access and treatment. For example, saying that a patient has a “substance use disorder” has a neutral tone and distinguishes the person from their diagnosis. While saying someone is a “drug addict,” characterizes a person using a single trait. The data that support the findings of this study are available from University of Pretoria but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available.

In spite of legislation created to prevent financial barriers to mental health care, insurers often pay lower rates to mental health providers than other medical professionals, so fewer therapists and psychiatrists can afford to accept insurance. One study found that only 20 percent of mental health practitioners accept insurance. Those who “got better” or “didn’t need help anymore” were not asked about structural or attitudinal reasons for dropping out. For the purposes of this study, only those who dropped out from all sectors and gave a reason for dropping out of treatment were included in the analysis.

Contextual barriers

A high level of psychological distress often led to acknowledgment of a need for treatment. Some participants denied their problems or postponed treatment-seeking until the point they could not cope anymore. Furthermore, problems at school or at work caused by the disorder could be a reason to seek help. If you or a loved one are struggling with mental health or substance abuse, we can help. There are too many people out there suffering from addiction, too many youth impacted by the early onset of substance abuse, for us to just stand by.

Top Barriers to Mental Health Treatment

There are significant disparities in mental health care accessibility among different racial and ethnic groups. Onesurveyfinds that white adults (23%) are more likely than Black (13.6%) and Hispanic (12.9%) adults to seek and receive mental health treatment. In addition to the barriers discussed above, these disparities stem from a lack of diverse representation in the mental health field, language barriers, and implicit bias. Access to mental health care is crucial to helping individuals receive the necessary support to address their illnesses. However, today,more than halfof adults with mental illness in the U.S. do not receive the mental health treatment they need.

Lack of resources and support

Furthermore, adequate mental health literacy and recognition of symptoms seems to positively influence treatment-seeking from formal sources and mental health care use . Previous literature, including a systematic review on web-based interventions could not confirm a positive effect of mental health literacy on actual treatment-seeking behavior. This suggests that multiple factors play a role in treatment-seeking, alcohol tremors the shakes which is in line with the results from our study. The need for amendment of the health system’s infrastructure is both evident and supported by the WHO Mental Health Atlas, 2017 Edition . Infrastructural barriers may be the most integrated with aforementioned barriers, as stigma, finances, access to care, and policy are directly related to physical infrastructure and utilization.

Although low perceived need would be expected in mild cases, a substantial number of severe cases think that they do not need help. Low perceived need was also high in countries that differ widely in levels of development, although it is possible that a deeper analysis might show that these perceptions differ in important ways across cultural settings. Absence of more textured information makes it impossible to obtain deeper insights from these data, but it is certainly plausible to imagine that variation in mental health literacy – that is, in knowledge and beliefs about mental disorders – could be importantly involved.

This is how most of these individuals get lost when they have everybody criticising them. Stigma is the number one barrier whereby some of us, when people judge us, we no longer believe in ourselves. I would say among 60% or 70% of young adults don’t know of treatment, there is not enough information about COSUP or about these institutions and where they are.

One study revealed that out-of-pocket expenses more commonly exceeded upwards of $200 for mental therapists, psychiatric prescribers, and specialty care versus primary care for outpatient services. Development of novel treatments may be helpful, but we may get more bang for the buck by assuring that the medications we already have are properly used. To facilitate this, adherence barriers can be framed as physician/health system hurdles.

On the other hand, urban clinics and providers often have long waiting lists, and patients can suffer for months before they get a basic intake appointment. Finally, whilevirtual therapy today is much more common and accessibleto many, this option requires a reliable internet connection and can limit care if a person isn’t in a safe, trusted environment. This chapter reviews a variety of complicating factors that may arise during the course of treatment of hoarding and acquiring problems.

Barriers were categorized as attitudinal, economic, physical, political, and infrastructural. Attitudinal barriers were most prevalent; infrastructural barriers were least discussed. Policy and infrastructural implementations would mitigate interconnected barriers and improve health and wellbeing within Africa. In many cases, the general practitioner positively affected the pathway to care because of proper recognition of symptoms, encouragement to seek treatment and timely referral. However, also in our sample a few participants were dissatisfied with the role of their physician.

In South Africa, certified training for addiction counsellors is limited and there is no provision for an addiction specialty for health professionals . One strength of this study is its qualitative design, yielding an extensive amount of information on treatment-seeking behaviour. Furthermore, our study focused both on barriers and facilitating factors, which are not necessarily opposites and important to investigate separately . In contrast with previous studies, which mostly focused on patients with depression, we included participants with anxiety disorders as well. The distribution of barriers to seeking treatment was examined among respondents with any 12-month disorder who had not used services in the 12 months prior to interview and then repeated in the sub-sample of respondents who recognized the need for treatment.