School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal.
PLoS One. 2021 Apr 30;16(4):e0250694. doi: 10.1371/journal.pone.0250694. eCollection 2021.
To explore the factors affecting mental health service utilization from Primary Health Care facilities of Arghakhanchi district, a western hilly district of Nepal.
Mental health service utilization has many facilitating and hindering factors present at different socio-ecological levels. Stigma and lack of awareness in the community have been identified as the major barriers for mental health service demand and access worldwide.
A cross-sectional qualitative study was conducted in Arghakhanchi district of Nepal in July-August 2019 that collected information through face-to-face In-depth and Key Informant Interviews of three categories of participants selected judgmentally. Thirty-two purposively selected participants from the three categories were interviewed using validated interview guidelines. Thematic analysis was performed using RQDA package for EZR software. Validation of translated transcripts, member checking and inter-coder percent agreement were performed to maintain rigor in the study.
Mental health stigma and inadequate awareness were identified as major factors that caused barriers for mental health service utilization at community level. They also influenced different factors at other socio-ecological levels to act as barriers. Awareness in community along with accessibility and availability of comprehensive mental health services were recommended by the participants for increasing service utilization from Primary Health Care facilities.
Individual, family and community awareness could help reduce and/or eliminate mental health stigma. Accessibility of health facilities and availability of comprehensive mental health services in Primary Health Care facilities could help increase service utilization from those facilities.
探讨尼泊尔西部丘陵地区阿尔加汗恰尔地区基层医疗保健机构心理健康服务利用的影响因素。
心理健康服务的利用存在许多促进和阻碍因素，这些因素存在于不同的社会生态层次。在全球范围内，社区的污名化和缺乏意识被认为是心理健康服务需求和获取的主要障碍。
2019 年 7 月至 8 月，在尼泊尔阿尔加汗恰尔区进行了一项横断面定性研究，通过有针对性地选择三类参与者的面对面深入访谈和关键知情人访谈收集信息。从这三个类别中，有 32 名有目的地选择的参与者使用经过验证的访谈指南进行了访谈。使用 RQDA 软件包对 EZR 软件进行了主题分析。为了保持研究的严谨性，对翻译后的转录本进行了验证、成员检查和编码者百分比一致性检查。
心理健康污名化和意识不足被确定为社区一级心理健康服务利用的主要障碍。它们还影响了其他社会生态层面的不同因素，成为障碍。参与者建议在社区中提高认识，同时提高基层医疗保健设施中综合心理健康服务的可及性和可获得性，以增加服务的利用。
个人、家庭和社区意识有助于减少和/或消除心理健康污名。基层医疗保健设施的卫生设施可达性和综合心理健康服务的可获得性有助于增加这些设施的服务利用率。
