A Systematic Review on inequalities in access to mental healthcare services in low and middle-income countries | [Rawal Medical Journal • 2024]

Author(s):

1. Hasan Albarqi: Directorate of Health Affairs, Jeddah, Saudi Arabia

2. Ali Jaber Aqeli: Directorate of Health Affairs, Jeddah, Saudi Arabia

3. Marwan Mohammed Alsaati: King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia

4. Mansour Alsaadawi: Directorate of Health Affairs, Jeddah, Saudi Arabia

5. Mohammed Sami Basubrain: Directorate of Health Affairs, Jeddah, Saudi Arabia

6. Lama Rashid Elessawi: Directorate of Health Affairs, Jeddah, Saudi Arabia

Abstract:

Objective: To identify health inequalities of access to health services for mental health patients in low and middle-income countries. Methodology: This systematic review was conducted through electronic article search on three journal databases: PubMed, ProQuest and CINAHL Plus with full texts. Additional search was done through Google Scholar and list of references. The articles were selected based on specific criteria and keenly read for quality of information and internal validity. Articles published within the last 10 years (2013-2023) with full-access were included. Results: A total of 4064 articles were retrieved, out of which, 17 were included as eligible. The studies were conducted in various low and middle-income countries, including Brazil, South Africa, Nigeria, Uganda, Kenya, India, Nepal, Ethiopia, Liberia, Surabaya, Rwanda, Jordan, Pakistan, Iran, and Mexico. Twelve studies applied quantitative methods, seven applied qualitative approach and one study used mixed research methodology. Three categories of health inequalities were identified: biological, including gender, age, and comorbidities; social, including race, culture, stigma, trust, family support, fear, attitude, economic status, and literacy-related variables; and structural, including place of residence, distance, accessibility, and availability of the services. Conclusion: Stigma from social norms lead the inequalities in access to mental healthcare services in developing countries.

Page(s): 1-6

DOI: DOI not available

Published: Journal: Rawal Medical Journal, Volume: 49, Issue: 1, Year: 2024

Keywords:

Low income , Inequalities , Systematic review , mental healthcare , middle income

References:

[1] .2022 .. Mental disorders, : .

[2] 2019 Mental Disorders GBD,Psychiatry Lancet . .-2019: a systematic analysis for the Global Burden of Disease Study 2019. 2022 Feb;9, (2) : 137-50.

[3] Pathare S,Brazinova A,Levav I. . .Care gap: a comprehensive measure to quantify unmet needs in mental health. Epidemiol Psychiatr Sci. 2018 Oct, 9(5) : 463-7.

[4] McCartney G,Collins C,Mackenzie M. .2013 .What (or who) causes health inequalities: Theories, evidence. , 113(3) : 221-7.

[5] Aguwa C,Carrasco T,Odongo N,Riblet N. . .Barriers to Treatment as a Hindrance to Health and Wellbeing of Individuals with Mental Illnesses in Africa: a Systematic Review. Int J Ment Health Addict. 2023 Aug, 10(4) : 2354-70.

[6] Masemola HC,Moodley S V.,Shirinde J . .Perceptions and attitudes of black men in a rural district of South Africa towards depression and its treatment. 2022 Jul, 28(1) : .

[7] Amone-P'Olak K,Kakinda AI,Kibedi H,Omech B . .Barriers to treatment and care for depression among the youth in Uganda: The role of mental health literacy. Front Public Health. 2023 Mar, 2 : 11.

[8] Gichimu EW,Rono C,Kihara M. Mental C .2021 .Disorders and Help-Seeking Behavior among Adults Attending Nyeri County Referral Hospital, Kenya. Afr J Educ Sci Technol, 63(3) : 233-45.

[9] Topper K,vanRooyen K,Grobler C,vanRooyen D,Andersson LMC . .Posttraumatic Stress Disorder and Barriers to Care in Eastern Cape Province, South Africa. J Trauma Stress. 2015 Aug, 13(4) : 375-9.

[10] Bawadi H,Al-Hamdan Z,Khader Y,Aldalaykeh M. . .Barriers to the use of mental health services by Syrian refugees in Jordan: a qualitative study. Eastern Mediterranean Health J. 2022 Mar, 29(3) : 197-203.

[11] Lagunes-Cordoba E,Davalos A,Fresan-Orellana A,Jarrett M,Gonzalez-Olvera J,Thornicroft G . .Mental Health Service Users' Perceptions of Stigma, From the General Population and From Mental Health Professionals in Mexico: A Qualitative Study. Community Ment Health J. 2021 Jul, 5(5) : 985-93.

[12] Husain W. . .Barriers in Seeking Psychological Help: Public Perception in Pakistan. Community Ment Health J. 2020 Jan, 21(1) : 75-8.

[13] Mrejen M,Hone T,Rocha R .2022 .Socioeconomic and racial/ethnic inequalities in depression prevalence and the treatment gap in Brazil: A decomposition analysis. SSM Popul Health, 20 : 101266.

[14] Tristiana RD,Yusuf A,Fitryasari R,Wahyuni SD,Nihayati HE .2018 .Perceived barriers on mental health services by the family of patients with mental illness. Int J Nurs Sci, 5(1) : 63-7.

[15] Kisa R,Baingana F,Kajungu R,Mangen PO,Angdembe M,Gwaikolo W . .Pathways and access to mental health care services by persons living with severe mental disorders and epilepsy in Uganda, Liberia and Nepal: a qualitative study. 2016 Dec, 31(1) : 305-9.

[16] Lopes CS,Hellwig N,Menezes PR . .Inequities in access to depression treatment: results of the Brazilian National Health Survey - PNS. Int J Equity Health. 2016 Dec, 17(1) : 154-8.

[17] Mekonen T,Chan GCK,Connor J,Hall W,Hides L,Leung J . .Treatment rates for alcohol use disorders: a systematic review and meta‐ analysis. Addiction. 2021 Oct, 116(10) : 2617-34.

[18] Andersson LMC,Schierenbeck I,Strumpher J,Krantz G,Topper K,Backman G,Disord J Affect .2013 .Help-seeking behaviour, barriers to care and experiences of care among persons with depression in Eastern Cape, South Africa. , 151(2) : 439-48.

[19] Chisholm D,Docrat S,Abdulmalik J,Alem A,Gureje O,Gurung D . .Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project - CORRIGENDUM. 2021 Jul, 25(4) : e117.

[20] Umubyeyi A,Mogren I,Ntaganira J,Krantz G . .Helpseeking behaviours, barriers to care and self-efficacy for seeking mental health care: a population-based study in Rwanda. 2016 Jan, 3(1) : 81-92.

[21] Saade S,Lamarche AP,Khalaf T,Makke S,Legg A . .What barriers could impede access to mental health services for children and adolescents in Africa? A scoping review. BMC Health Serv Res. 2023 Apr, 6(1) : 348-53.

[22] Ebrahimi H,Seyedfatemi N,Namdar Areshtanab H,Ranjbar F,Thornicroft G,Whitehead B . .Barriers to Family Caregivers' Coping With Patients With Severe Mental Illness in Iran. Qual Health Res. 2018 May, 24(6) : 987-1001.

[23] Al Omari O,Khalaf A,Al Sabei S,Al Hashmi I,Al Qadire M,Joseph M . .Facilitators and barriers of mental health help-seeking behaviours among adolescents in Oman: a cross-sectional study. 2022 Nov, 1(8) : 591-601.

[24] Löckenhoff CE,MiniReview. Gerontology CE .2018 .Aging and Decision-Making: A Conceptual Framework for Future Research -. , 64(2) : 140-8.

[25] Thompson AE,Anisimowicz Y,Miedema B,Hogg W,Wodchis WP,Aubrey-Bassler K. . .The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study. 2016 Dec, 31(1) : 38.

[26] Nicholas A,Joshua O,Elizabeth O. Accessing Mental O .2022 .Health Services in Africa: Current state, efforts, challenges and recommendation. Ann Med Surg, 81 : 104422.

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