The challenges faced by service providers on satellite mental health-care facilities in Yangon, Myanmar: a qualitative study

Kyaw Lin,Sun Lin,Than Tun Sein

doi:10.1108/jhr-02-2020-0029

Abstract

PurposeMyanmar has an insufficient number of mental health workers with few institutional facilities resulting in a significant treatment gap. Although few mental health services are integrated into primary health care (PHC), the challenges are unknown. This study aimed to assess the challenges perceived by providers in the service delivery of satellite mental health care (SMHC) in two sample townships in Yangon.Design/methodology/approachThe research was based on a case study design by applying a qualitative approach using in-depth interviews (IDIs). In the three types of service providers, a total of six staff participated as interviewees. These consisted of two team leaders, two clinical specialists providing consultations to clients and two mental health nurses.FindingsProviders perceived the following as major challenges in the provision of services: unstable financial resources and management, insufficient human resources and capacity of service providers, restricted outpatient services, the lack of a functional referral system, overcrowding, inadequate individual consultation time, long-waiting hours, finite opening days and hours and poor setting of infrastructure, resulting in lack of privacy.Research limitations/implicationsIn the absence of similar studies in Myanmar, findings could not be placed in the context of the national literature for comparison. Further, the study involved a limited number of respondents, which may have affected the findings.Originality/valueAlthough the challenges revealed were not uncommon in mental health services in developing countries, this study focused on a specific model of mental health care integrated into general healthcare settings in Myanmar. The findings offer a benchmark on efforts to develop decentralized mental health services in Myanmar and provide input for future in-depth studies.

Highlights

Mental health continues to be one of the most neglected public health issues despite the increasing prevalence of mental health disorders worldwide
The findings offer a benchmark on efforts to develop decentralized mental health services in Myanmar and provide input for future in-depth studies
This study focused on the identification of challenges in the provision of services from the providers’ perspective in two satellite mental health care (SMHC) sites in Yangon

Summary

Introduction

Mental health continues to be one of the most neglected public health issues despite the increasing prevalence of mental health disorders worldwide. Mental health services can be classified into three main types: community-based services, services integrated into primary care and specialized institutional or hospital services [1] (Figure 1). Individual countries may face different challenges depending on the types of mental health services provided. In many developing countries, restricted human resources [2], inaccessibility to mental health professionals [3] and inappropriate health-care settings [4] are found to be common challenges. Mental health hospitals are notorious for their stigmatization [1] and violation of basic human rights [1, 5]. Other important challenges include the following: low ranking as a health system priority, inadequate capacity in management, insufficient training of general practitioners (GPs), the absence of orientation to integrated care, a high turnover of staff, inefficient intersector coordination, poor infrastructure and insufficient budget allocation [4]

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