Reviewer ’s report  
 
Title:  Perceptions of Mexican Women Regarding Barriers in Mental Health Services in Primary 
Care.  
 
Version: 1 Date: 03 Feb 2017 
 
Reviewer:  Melanie  Straiton  
 
Reviewer’s report:  
 
The authors have done a good job with the revisions; the aim is clearer and the results and 
discussion fit better together. However, there are stil l some aspects that need to be addressed in 
the current draft in order to lead the reader logically through the study. The method in particular 
would benefit from restructuring it. The article also has some very short paragraphs - some of 
these could be pu t together. Also at times in the method and results, the participants are referred 
to as respondents. This makes them sound passive which goes against the nature of qualitative 
interviews where participants actively engage and shape the data collection. I' d advise changing 
all instances of respondents to participants.  
 
 
Abstract: the categorisation of meaning approach is still confusing in this instance - Is this just 
thematic analysis? If so, please refer to it as this.  
 
 
Introduction: P6, line 38 -institution  should perhaps be avoided here as in terms of health care, it 
brings to mind inpatient services.  
 
P8, line 40 -46: characteristics of the health care provider are also important in the literature (as 
you also find).  
 
P9, lines 18 -24: references should be p rovided here - not just at the end of the paragraph.  
 
P10, lines 16 -23: this is written as if the results have already been presented. Plus, it doesn't 
really follow that there will be two types of knowledge from the article. Perhaps reword it (and 
combine with the paragraph above). Eg. This study seeks to id entify…City. Updated information 
on barriers mental health care is important in light …PH. Further, we focus on the opinions of a 
group …conditions. Their care needs…  
 
 
Methods: The first paragraph seems redundant - I'd suggest deleting it - perhaps also in  the 
abstract too.  
 
 
Participants: Focus here on the describing the sample . the first paragraph is part of the 
procedure.  
Setting: It might be useful to have this prior to the participants section? Also mention which 
levels of centres you recruited from - or more simply for the reader - how many of the centres 
you recruited from had psychological services available? Also, I find the use of 'module' a little 
confusing. Would service or unit be appropriate? Both here and other places in the paper.  
 
 
Techniques a nd instruments: Procedure might be a better title? Mention at the beginning of this 
section that it was part of a larger study (aim of the larger study) Line 33 - area explored in this 
article.  
 
 
Information analysis: Data analysis more appropriate?  
 
P 15, l ines 16 -46: this could either appear under a separate heading of ethical considerations or 
be included under the procedure section (except the last setting which may belong under data 
analysis.  
 
 
Results: The first paragraph seems oddly placed as it is not p art of the procedure. Does it fit 
better in the introduction or method section?  
 
 
Unawareness of the psychology service: although the authors describe this theme as a system 
barrier, the name of this theme sounds more like an individual barrier - placing the  onus on the 
women, instead of the poor distribution of information. Can you rename it to something more 
fitting?  
 
 
Irregularity in consultations and inconvenient schedules: On their own, these stand as quite weak 
themes given the lack of interpretation - to me they are similar in that they both relate to the 
limited availability of services.  
 
 
The pricacy of personal problems: can this theme be developed more to include authors 
interpretations? Is it about maintaining the fasace of happy family life or is it a bout being self -
reliant and the ability to cope themselves? Is there self -blame about their situation?  
 
 
Mistrust of treatment: Social imaginary is a confusing  
 
 
Charateristics and attitudes of the psychologists: I am not sure as to what point the authors ar e 
making here - the description focuses on characteristics but the quote indicates that is is only the 
attitude the woman reacted too.  
Discussion: limitations should not come after the conclusion but incorporated into the discussion. 
It would also be inte resting to see methodological reflections about the role of the researchers in 
relation to data analysis.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you  recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
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3. Do you hold or are you currently applying for any patents relating to the content of the 
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4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
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