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Daliri DB, Aninanya GA, Laari TT, Abagye N, Dei-Asamoa R, Afaya A. Exploring the barriers to mental health service utilization in the Bolgatanga Municipality: the perspectives of family caregivers, service providers, and mental health administrators. BMC Health Serv Res 2024; 24:278. [PMID: 38443928 PMCID: PMC10916073 DOI: 10.1186/s12913-024-10567-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/05/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Mental health service utilization remains a challenge in developing countries, with numerous barriers affecting access to care. Albeit data suggest poor utilization of mental health services in the Bolgatanga Municipality in Ghana, no studies have explored the barriers to the utilization of mental health services. Therefore, this study explored the perspectives of family caregivers, service providers, and mental health service administrators on the barriers to mental health service utilization in the Bolgatanga Municipality, Ghana. METHODS A qualitative descriptive design was employed for the study. Nineteen participants were purposively sampled from two hospitals including fifteen family caregivers, two service providers, and two mental health administrators. Data were collected through individual in-depth interviews using a semi-structured interview guide. Audio-recorded interviews were transcribed verbatim and thematically analyzed using NVivo 12 pro software. RESULTS Five main themes emerged including individual-level barriers, interpersonal barriers, community-level barriers, organizational-level barriers, and policy-level barriers. At the individual level, lack of insight, poor treatment compliance, and financial challenges were prominent barriers. Interpersonal barriers included family pressure influenced by cultural and spiritual beliefs. At the community level, stigma and mental health illiteracy were identified as significant barriers. At the organizational level, barriers encompassed inadequate staffing, limited space, and staff attitudes. Policy-level barriers included the neglect of mental health in policies and the non-inclusion of mental health services in the National Health Insurance Scheme. CONCLUSION This study highlights the complexity of barriers to mental health service utilization and underscores the need for a comprehensive approach to address them. Collaborative efforts involving healthcare providers, policymakers, communities, and families are essential to mitigate these barriers. It is imperative to consider these barriers when developing strategies to improve the utilization of mental health services in Ghana.
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Affiliation(s)
- Dennis Bomansang Daliri
- Presbyterian Psychiatric Hospital, Bolgatanga, Ghana
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Gifty Apiung Aninanya
- Department of Health Services Policy Planning Management and Economics, School of Public Health, University for Development Studies, Tamale, Ghana
| | | | - Nancy Abagye
- Department of Midwifery, School of Nursing and Midwifery, University of Ghana, Legon, Ghana
| | - Richard Dei-Asamoa
- Department of Psychiatry, Korle-Bu Teaching Hospital, Accra, Ghana
- Department of Psychiatry, University of Ghana Medical School, Accra, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
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Andary S, Bassani J, Burrell G, Cole E, Evans R, Redman E, Kumar S. Barriers and enablers to access and utilization of mental health care services across Southeast Asia: A preliminary scoping review. Asia Pac Psychiatry 2023; 15:e12549. [PMID: 37735090 DOI: 10.1111/appy.12549] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 08/29/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
While the importance of mental health and its impact on overall health and well-being has been widely recognized, there continue to be ongoing barriers to accessing mental health services. This is particularly poignant in countries in Southeast Asia (SEA) where there may be further stigma in accessing mental health services. As no reviews have been undertaken on this topic, this review aims to outline the barriers and enablers to access and utilization of mental health care services in SEA. Searches were undertaken in commercially produced and gray literature sources. Two independent reviewers screened the results. The data were then independently extracted, which was then collated and synthesized, using the Health Belief Model (HMB) as a framework. Twelve studies were included in the review. Under the HBM, barriers were grouped into: stigma, poor health literacy, internalized reasons, cultural beliefs, lack of training of health professionals, quality of service, and poor distribution of resources. Enablers included: social support, outreach services, structural stigma, self-awareness, resources and information, accessibility and affordability, and positive attitudes and beliefs about health professionals. Those accessing mental health care in SEA are confronted by complex barriers and few enablers. Ongoing stigma and a distinct lack of resources pose the greatest challenges, which are even more amplified for those in rural areas and minority groups. A multifaceted strategy that improves the structures, processes, and outcomes of mental health is required within these communities.
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Affiliation(s)
- Sleiman Andary
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Jason Bassani
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Gus Burrell
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Eliza Cole
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Rhiannon Evans
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Emily Redman
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Saravana Kumar
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Ishak N, Mukhtar F, Munawar K, Coudhry FR, Roy M, Jalal FA, Choi CS. Psychological assessment of atopic dermatitis in Asia: a systematic review. PSYCHOL HEALTH MED 2023; 28:1-26. [PMID: 35000520 DOI: 10.1080/13548506.2021.1971727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Atopic dermatitis (AD) is a frequently occurring skin disorder in Asia that substantially impacts the social, financial, and psychological lives of individuals. However, there is uncertainty regarding the psychological instruments for this domain. Hence, this review systematically assessed the existing measurement instruments used, developed, and/or validated for the measurement of psychological outcomes in Asian adult patients with AD as well as the scope of those assessment tools (e.g. validity and reliability). Electronic searches were performed using six databases (inception to February 2020) to identify studies. Thematic analysis of 44 included studies revealed that the commonly employed tools to assess the quality of life were the Dermatology Life Quality Index followed by the Skindex-16 questionnaire, the European Quality of Life-5 Dimensions, and the Quality of Life Hand Eczema Questionnaire. Similarly, the Patient Health Questionnaire, Self-rating depression scale (SDS), and Hospital Anxiety and Depression Scale were frequently employed to assess depressive symptoms. Additionally, symptoms of anxiety were frequently assessed through Interaction Anxiousness Scale and the Spielberger State-Trait Anxiety Inventory. Although a variety of psychological assessment measures have been used in research, data on their reliability and validity is limited. Also, information on the cultural applicability of these instruments is scantier. More research is needed to ascertain the suitability of tools for use in clinical practice.
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Affiliation(s)
- Nurhafidah Ishak
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Firdaus Mukhtar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Khadeeja Munawar
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, Ucsi University Malaysia, Cheras, Kuala Lumpur, Malaysia.,Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Fahad Riaz Coudhry
- Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur Malaysia
| | - Mollika Roy
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Farah Atiqah Jalal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Chong Seng Choi
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Bhamani SS, Arthur D, Van Parys AS, Letourneau N, Wagnild G, Premji SS, Asad N, Degomme O. Resilience and prenatal mental health in Pakistan: a qualitative inquiry. BMC Pregnancy Childbirth 2022; 22:839. [PMID: 36376896 PMCID: PMC9664804 DOI: 10.1186/s12884-022-05176-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention. Methods The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A total of 17 semi-structured interviews were conducted with pregnant women, purposefully selected with heterogeneous characteristics to explore diverse perspectives, while symptoms of depression were quantified by the Edinburgh Postnatal Depression Scale before the interview. Verbatim transcriptions were coded openly and merged into categories and themes. Result A total of six themes emerged from in-depth thematic analysis: 1) purpose of life, 2) dealing with emotions, 3) believing in yourself, 4) optimistic approach, 5) strengthening support and relationship and 6) spirituality and humanity. Women agreed that these characteristics could help them improve their mental health. Conclusion In conclusion, these themes were the core components of pregnant women’s resilience which ultimately could help to promote prenatal mental health. These pave a pathway towards developing culturally and contextually resilience interventions aimed at enhancing mental health of pregnant women which then may improve neonatal and family mental wellbeing.
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Goodwin J, Savage E, O’Donovan A. “I Personally Wouldn’t Know Where to Go”: Adolescents’ Perceptions of Mental Health Services. JOURNAL OF ADOLESCENT RESEARCH 2022. [DOI: 10.1177/07435584221076056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to explore perceptions of mental health services from the perspectives of adolescents with no prior service experience. Thirty students in the Transition Year (fourth year) of secondary school participated in this study: 22 females and 8 males, aged 15 to 16. There was equal distribution across rural and urban settings. Participants had no prior experience of accessing mental health services. Data were collected in secondary school settings in the Republic of Ireland. An interpretive description approach guided this study. Data were collected through individual interviews. To complement interviews, participants drew images of mental health care environments and mental health staff members; drawings were not subjected to analysis. Data (participant interviews) were analyzed using qualitative content analysis. Three themes were identified. Participants suggested that “mental health services” differed from “psychiatric services,” with the latter term perceived more negatively. Uncertainty about how to access these services was voiced. Considering the vulnerability of adolescents to the experience of mental distress, education around mental health services is warranted. It is expected that provision of education in this area would enhance service delivery, improve adolescents’ help-seeking behaviors for mental distress, and reduce stigma.
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