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

• Published in: Community mental health journal Vol. 57; no. 5; pp. 836 - 852
• Main Authors: Sarikhani, Yaser, Bastani, Peivand, Rafiee, Mohammad, Kavosi, Zahra, Ravangard, Ramin
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2021; Springer Nature B.V
• Subjects: Barriers; Community and Environmental Psychology; Community mental health services; Content analysis; Developing Countries; Health care delivery; Health care policy; Health insurance; Health Policy; Health problems; Health Services Accessibility; Health services utilization; Humans; Integrated care; LDCs; Legislation; Low income groups; Medicine; Medicine & Public Health; Mental health; Mental health care; Mental Health Services; Original Paper; Psychiatry; Public health; Social Stigma; Socioeconomic factors; Stigma; Provision; Access; Mental Health; Utilization; Mental Health Services; Barriers
• DOI: 10.1007/s10597-020-00619-2
• ISSN: 0010-3853

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.