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Background <p>The mental health burden and associated costs are considerable, which is posing challenges for public health delivery systems because of the increased treatment gap, especially in low- and middle-income countries. It is therefore important to investigate the factors influencing access to mental health care from the perspectives of different stakeholders to gain meaningful insights. This study was conducted to assess the existing barriers and facilitators using a socioecological model.</p> Methods <p>A qualitative study involving in-depth interviews (IDIs) and focus group discussions (FGDs) at health care facilities was conducted with 24 service users (diagnosed with depression and anxiety) and 21 health care professionals. Thematic analysis was performed and presented using a socioecological model to enhance clarity and impart recommendations.</p> Results <p>The results suggest that there are four levels of persisting impediments and facilitators while accessing mental health care in Sudurpaschim Province: (1) Individual level- education, exposure to mass media and women’s empowerment (facilitators) but unawareness and side effects of medication (barriers); (2) Community level: community involvement and awareness (facilitators) while stigma, discrimination, misconceptions, and adverse environments (barriers); (3) Organizational level: psychosocial counselling and effective communication (facilitators) while limited accessibility and availability of MHS (barriers); and (4)&#xa0;Policy level: existing policy and strategies (facilitators) while political indifference, implementation gap and low budget allocation (barriers).</p> Conclusions <p>This qualitative study presents a complex, interconnected set of multi-layered barriers and facilitators influencing access to mental health care in Sudurpaschim, Nepal. From the socioecological view, the findings suggest that a comprehensive approach that integrates efforts across all levels are equally essential to effectively address these barriers and facilitators.</p>

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Exploring barriers and facilitators of mental health care in Sudurpaschim Province, Nepal: a socioecological qualitative study of patients with depression and anxiety and health care professionals

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月1日

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  • Gayatri Khanal,
  • Y. Selvamani,
  • Prabhat Sapkota

摘要

Background

The mental health burden and associated costs are considerable, which is posing challenges for public health delivery systems because of the increased treatment gap, especially in low- and middle-income countries. It is therefore important to investigate the factors influencing access to mental health care from the perspectives of different stakeholders to gain meaningful insights. This study was conducted to assess the existing barriers and facilitators using a socioecological model.

Methods

A qualitative study involving in-depth interviews (IDIs) and focus group discussions (FGDs) at health care facilities was conducted with 24 service users (diagnosed with depression and anxiety) and 21 health care professionals. Thematic analysis was performed and presented using a socioecological model to enhance clarity and impart recommendations.

Results

The results suggest that there are four levels of persisting impediments and facilitators while accessing mental health care in Sudurpaschim Province: (1) Individual level- education, exposure to mass media and women’s empowerment (facilitators) but unawareness and side effects of medication (barriers); (2) Community level: community involvement and awareness (facilitators) while stigma, discrimination, misconceptions, and adverse environments (barriers); (3) Organizational level: psychosocial counselling and effective communication (facilitators) while limited accessibility and availability of MHS (barriers); and (4) Policy level: existing policy and strategies (facilitators) while political indifference, implementation gap and low budget allocation (barriers).

Conclusions

This qualitative study presents a complex, interconnected set of multi-layered barriers and facilitators influencing access to mental health care in Sudurpaschim, Nepal. From the socioecological view, the findings suggest that a comprehensive approach that integrates efforts across all levels are equally essential to effectively address these barriers and facilitators.