Abstract
BackgroundIndividuals with schizophrenia in low- and middle-income countries and their caregivers face multiple barriers to care-seeking and continuous engagement with treatment services. Identifying specific barrier patterns would aid targeted interventions aimed at improving treatment access.AimThe aim of this study was to determine stigma- and non-stigma-related barriers to care-seeking among persons with schizophrenia in Nigeria.SettingThis study was conducted at the Outpatient Clinics of the Federal Neuro-Psychiatric Hospital, Benin City, Nigeria.MethodsA cross-sectional study of a dyad of persons with schizophrenia and caregivers (n = 161) attending outpatient services at a neuro-psychiatric hospital in Nigeria. Stigma- and non-stigma-related barriers were assessed using the 30-item Barriers to Access to Care Evaluation (BACE) scale.ResultsLack of insight, preference for alternative care, illness severity and financial constraints were common barriers to care-seeking among persons with schizophrenia. Females were significantly more likely to report greater overall treatment barrier (p < 0.01) and stigma-related barriers (p < 0.02).ConclusionThis study shows that attitudinal barriers impede care access and engagement among persons with schizophrenia in Nigeria.
Highlights
Individuals with schizophrenia in low- and middle-income countries and their caregivers face multiple barriers to care-seeking and continuous engagement with treatment services
Over 21 million people globally live with schizophrenia, a disabling mental disorder, affecting approximately 4–5 million individuals living in African countries.[1]
In Nigeria, pathways to care for mental disorders are complex and significantly influenced by stigma, poor understanding about these illnesses, cultural and religious factors, financial constraints, and poor integration of mental healthcare into primary healthcare systems.[2,3]
Summary
Individuals with schizophrenia in low- and middle-income countries and their caregivers face multiple barriers to care-seeking and continuous engagement with treatment services. Some research has been conducted on pathways to care for mental disorders in Nigeria,[6,7] there is a lack of evidence for the specific barriers (from the perspective of patients with schizophrenia and their caregivers) that prevent or discourage them from accessing mental health services or continuing with services after initial engagement. In developing countries, income-related disparities serve as major non-stigma barriers to healthcare access.[8,9,10]
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