Barriers to Mental Health Services Utilization
Authors: - Iswori Khanal 
Published: December 2024

The use of health services is defined as the process of seeking professional healthcare and submitting oneself to the application of regular health services with the purpose to prevent or treat health problem .Person suffering from mental illness usually face different barriers . The problem of underutilization of mental health services may be due to: (1) barriers to initiation of mental health services and (2) barriers to persistence in treatment once it is sought. People with a number of unmet needs are likely to experience poor quality of life as well. Any mental health service that aims to improve the quality of life of patients’ needs to actively assess for these factors as early recognition can help in optimizing planning of treatment and implementation of care ensuring effectiveness of psychiatric care. It also plays a critical role in mental health rehabilitation Such an identification could lead to implementation of targeted stigma reduction strategies in addition to regular management plan.
Methodology

A cross sectional study was performed in Mental Hospital, Lalitpur, Nepal. People suffering from mental illness who fulfilled the inclusion criteria were recruited and BACE scale was administered along with relevant details of participants .
Results

Most of the participants were from Bagmati Province (65.1%, n=192) whereas least participation was from Sudurpaschim Province (2.1%, n=6). The mean age of participants was 35 years with majority belonging to the age group of 26-35 years (37.3%, n=109). The participation of males (54.5%, n=159) was greater than that of females (45.5%, n=133). The participation of divorced and widow/er was very less (2.4%, n=7) compared to those who were married (71.2%, n=208) or

unmarried (26.4%, n=77). A vast majority were Hindus (77.4, n=226) followed by Buddhist (12%,N=35 and Christians (9.6%, n=28 ) and others (1%,n=3). Majority of the participants had completed their higher secondary (38.4%, n=112) and secondary (19.5%, n=57) education followed by no formal education (13.4%,n=39) and those with post graduate education and above (1.7% ,n=5). Regarding occupation, the number of unemployed (36.6%, n=107) was highest followed by service holders (17.8%, n=52), others (16.1%, n=47 ),farmer (15.8%,n=46) and business owners (13.7%, n=40) respectively. Socioeconomic status was measured using Kuppuswamy scale and it was found that most of the participants belonged to middle (63.4%, n=185) followed by upper (22.6%, n=66) and lower (14%, n=41) socioeconomic status.
Among the patient reported barriers related to stigma ,the most reported concern was “ concerned that I might be seen as weak for having a mental health problem “(33.6 %),followed by “concern that I might be seen as crazy “ (26.4%) ,followed by “Concern that my children may be taken into care or that I may lose access or custody without my agreement “ (22.6%) and ” feeling embarrassed or ashamed “ (21.6 %) . Among the reported instrumental barriers in BACE scale , “having no one who could help me get professional care (18.2)“ was the most reported major barrier followed by “ being unsure where to get professional care “(17.8)“ followed by being too unwell to ask for help “ (14.4%). Among the different attitudinal components in BACE scale “wanting to solve problem on my own” (21.9%) was the most reported barrier followed by “dislikes of talking about my feelings, emotions or thought “(19.5%) and “thinking that I don’t have problem”(17.8%).

Conclusion

Thus, it can be concluded that people people suffering from mental illness also experience different barriers during help seeking . This barriers is found more on people below 45 years of age and people with low socio economic status . This barriers influences the quality of life in terms of decline in physical health and environment.