Key Barriers to the Provision and Utilization of Mental Health Services in Low-and Middle-Income Countries: A Scope Study.

Yaser Sarikhani,Ramin Ravangard,Zahra Kavosi,Mohammad Rafiee,Peivand Bastani

doi:10.1007/s10597-020-00619-2

Yaser Sarikhani, Ramin Ravangard + Show 3 more

Open Access

https://doi.org/10.1007/s10597-020-00619-2

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Abstract

Inadequate attention has been given to the provision of mental health (MH) services especially in low-and middle-income countries (LMICs). This study was aimed to identify key barriers to provide and utilize MH services in LMICs. A comprehensive search on7 important online databases was conducted for key barriers to the provision and utilization MH services in LMICs from Jan 2000 to Nov 2019. Five-step Arksey and O'Malley guideline was used for scope study. The extracted data were synthesized using a qualitative content analysis and thematic network. Three main themes identified as barriers to the provision of MH services in LMICs, namely resource and administrative barriers, information and knowledge barriers, as well as policy and legislation barriers. Also attitudinal barriers, structural barriers, knowledge barriers, and treatment-related barriers were four main themes emerged regarding the challenges of utilization of MH services. Equitable access to MH services in LMICs is influenced by many barriers in both provision and utilization sides. In order to alleviate these problems, health systems could adopt some strategies including integration of MH into the general health policy, improvement of public MH awareness, developing anti-stigma programs, reallocation of health resources toward high-priority MH needs, developing community-based insurance, as well as integration of MH services into all levels of health-care systems. The success of intervention strategies depends on the weight of these barriers in different socio-economic contexts.

Highlights

Mental health (MH) is among the leading determinants of people's overall well-being (1)
Equitable access to MH services in low-and middle-income countries (LMICs) is under influence of many barriers in both provision and utilization sides
Thematic analysis resulted in development of 3 main themes and 13 sub-themes regarding the barriers to the provision of MH services which are presented in table 3

Summary

Introduction

Mental health (MH) is among the leading determinants of people's overall well-being (1). Despite the increasing trend of global burden of mental illnesses, the problem has not been regarded appropriately like physical diseases and to a large extent has been neglected in many parts of the world specially in low-and middle-income countries (LMICs) (6–8) This defect leads to limited, inadequate, and inequitable provision of MH services (6), and would expand treatment gap. Mental Health(MH) is among the main determinants of community well-being and a remarkable portion of global burden of diseases is pertaining to mental disorders Despite this fact, little attention has been given to the provision of adequate and appropriate MH services and improving equitable access to these services in some parts of the world especially in low-and middle-income countries(LMICs).

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