Document Type : Original Article
Authors
1 National Institute of Social Defence, New Delhi, India
2 Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
Abstract
BACKGROUND: The Government of India and State Government authorities are trying their best to
provide adequate mental health services through various mental health policies and programs. To
reduce the burden in psychiatric hospitals, Government has decentralized mental health services.
Although Government has provided mental health services, the utilization has always been low due
to many reasons. In the present study, an attempt was made to assess the accessibility and the
barriers to utilizing mental health services with various community stakeholders.
MATERIALS AND METHODS: This is a qualitative study wherein data was collected from youth,
women, geriatric groups, community key leaders, and Anganwadi workers. The primary data were
collected through focused group discussions and interview methods. The collected data were
analyzed using thematic coding.
RESULTS: A total of twenty‑five factors have been identified in the study, which were categorized
under eight themes. (a) Lack of awareness and misinformation on mental health, illness, and
available services, (b) Perceived causes for mental illness, (c) Reasons for not approaching health
professionals, (d) Treatment adherence‑related issues, (e) No multidisciplinary team in private
hospitals and lack of involvement in government sector (f) Manpower issues, (g) Quality of service
issues and building confidence among community people, and (h) Belief system and stigma.
CONCLUSIONS: Inadequate mental health services, lack of awareness of mental health, and
illness are still persist. The District Mental Health Program and other service providers need to reach
communities, especially in remote areas. Periodical evaluation should be carried out to improve the
utilization of mental health services.
Keywords
Psychiatry 2005;17:103‑7.
2. Parekh R. What Is Mental Illness? American Psychiatric
Association; 2015; Available from: https://www.psychiatry.
org/patients‑families/what-is-mental-illness. Accessed on
20 December 2017.
3. Gururaj G, Varghese M, Benegal V, Rao GN, Pathak K,
Singh LK, et al. National Mental Health Survey of India, 2015‑16:
Summary. Bengaluru: National Institute of Mental Health and
Neurosciences; 2016.
4. Roy S, Rasheed N. The National Mental Health Programme of
India. Int J Curr Med Appl Sci 2015;7:7‑15.
5. Ministry of Health & Family Welfare Government of India.
National Mental Health Programme. Available from:
http://164.100.158.44/WriteReadData/l892s/mental%20
health%20care%20bill%202013.pdf. Accessed on 30 March
2018.
6. Chandramouli C, General R. Census of India 2011. Provisional
Population Totals. New Delhi: Government of India; 2011.
7. Varkevisser CM, Pathmanathan I, Brownlee AT, Brownlee A.
Designing and Conducting Health Systems Research Projects.
Ottawa IDRC; 2003.
8. Gibbs GR, Taylor C. Learning qualitative data analysis on the
web. Retrieved October. 2010;12:2017.
9. Ministry of Health and Family Welfare Services, Govt. of
Karnataka. Directorate of Health, Govt. of Karnataka; 2019.
Unpublished data.
10. Sangeetha V, Lakshmana G. Service providers’ perception of
barriers to access mental health services. Indian J Psychiatr Soc
Work 2019;10:3‑12.
11. Wig NN, Srinivasa Murthy R, Harding TW. A model for rural
psychiatric services: Raipur Rani experience. Indian J Psychiatry
1981;23:275‑90.
12. Shidhaye R, Kermode M. Stigma and discrimination as a
barrier to mental health service utilization in India. Int Health
2013;5:6‑8.
13. Knapp M, Funk M, Curran C, Prince M, Grigg M, McDaid D.
Economic barriers to better mental health practice and policy.
Health Policy Plan 2006;21:157‑70.
14. Tristiana RD, Yusuf A, Fitryasari R, Wahyuni SD, Nihayati HE.
Perceived barriers on mental health services by the family of
patients with mental illness. Int J Nurs Sci 2018;5:63‑7.
15. Thara R, Padmavati R, Aynkran JR, John S. Community mental
health in India: A rethink. Int J Ment Health Syst 2008;2:11.
16. Aruna G, Mittal S, Yadiyal MB, Acharya C, Acharya S,
Uppulari C. Perception, knowledge, and attitude toward mental
disorders and psychiatry among medical undergraduates
in Karnataka: A cross‑sectional study. Indian J Psychiatry
2016;58:70‑6.
17. Kaur R, Pathak RK. Treatment Gap in Mental Healthcare;
Reflections from Policy and Research; 2017. Available
from: https://www.epw.in/journal/2017/31/perspectives/
treatment‑gap‑mental‑healthcare.html?0=ip_login_no_cache%
3D0c9078aefdc42308f4809cd0bf3b0137.Accessed on 30 March
2019.
18. Velligan DI, Sajatovic M, Hatch A, Kramata P, Docherty JP.
Why do psychiatric patients stop antipsychotic medication? A
systematic review of reasons for nonadherence to medication in
patients with serious mental illness. Patient Prefer Adherence
2017;11:449‑68.
19. Rost K, Fortney J, Fischer E, Smith J. Use, quality, and outcomes of care for mental health: The rural perspective. Med Care Res
Rev 2002;59:231‑65.
20. Sinha SK, KaurJ. National mental health programme: Manpower
development scheme of eleventh five‑year plan. Indian J
Psychiatry 2011;53:261‑5.
21. Sivanandan A, Kumar SG, Krishnamoorthy Y. Awareness
and preference in utilizing primary health‑care services from
rural health center as first point‑of‑care: A community‑based
cross‑sectional study in South India. JEduc Health Promot 2020;9:85.
22. Mohammadi AS, Panahi S, Sayarifard A, Ashouri A. Identifying
the prerequisites, facilitators, and barriers in improving
adolescents’ mental health literacy interventions: A systematic
review. J Educ Health Promot 2020;9:322.
)