Exploring barriers in seeking mental health services

Abstract

Prevalence of mental health condition in Bangladesh indicates a huge need for psychological sufferer. However, many of inidviduals with the disorders do not seek psychiatric treatment. In the context of high treatment gap (92.3%) in our country it is important to explore the barriers to seek treatment for mental illness in Bangladesh, which was the objective of the present study. Qualitative research design using grounded theory approach was used for the aimed exploration. Eleven participants were interviewed including three groups which were patient group, non patient group and caregiver group. In the patient group there are two sub divisions; non treatment-seeker and delay treatment-seeker. Non seekers are those who go through the problem but did not receive any treatment and delay seeker reeived service after suffering a long time. For screening purpose SRQ-20 was administer. In-depth face to face interview was conducted by the researcher using a topic guide. Data analysis was done with support from qualitative reserach software. Analysis though open and axial coding identified twenty themes which were organized under eighteen sub-categorizes from four broad categories. The four categories were socio cultural barrier, perceptual barrier, experiential barrier and structural barrier. It was found that stigma and mental health are strongly connected with each other and different cultural beliefs make the condition worse. When a person goes for treatment, it becomes a part of social gossip. That reduces the social acceptance of a patient and his/her caregiver and they would be victimized by different types of discrimination. Perceptual barriers also play an important role, mostly of which is due to poor mental health literacy for which they do not perceive the need treatment. Patient and care giver do not give enough importance in mental health issue and also discourage patient to go for treatment. V Experiences around support around psychological problems also contribute towards the choice of seeking or not seeking treatment. Individuals adopt different types of alternative coping when they have psychological problems, and by giving some transient relief, these in turn creats a barrier to seek formal treatment. Additionally in our country there are limited resources, thus lack of availability and access act as a structural barrier for seeking treatment. Concerns about the inapropriate professional practices such as hasty interaction, judgmental approach, and violation of confidentiality among the mental health service providers also create a barrier for access. Finding of this study indicates that services seeking for mental health problems are contributed by factors from multiple dimensions. This research may contribute in planning and implementing intervention related to increasing access and thus help policy makers become more effective in ensureing quality service for patients with mental health conditions.