Mental health service utilization in a low resource setting: A qualitative study on perspectives of health professionals in Northwest Ethiopia

Abstract

Background Mental health services are advocated to move from specialized care to more integrated and accessible primary care settings. The integration of mental health into primary health services is expanding in Ethiopia. However, there is a lack of research on the perspectives of health professionals on mental health services in Ethiopia. This study aimed to explore the perspectives, views, and experiences of health professionals regarding mental health services and the help-seeking behavior of people with mental illness in Northwest Ethiopia. Methods This qualitative study included sixteen health professionals. The participants were interviewed using a semi-structured interview guide. Interviews were conducted in Amharic and translated into English. We analyzed the data using reflexive thematic analysis. Results Five key themes were generated from the interview data: (1) Avoidance of mental healthcare; (2) Low literacy about mental illness; (3) Stigma as a hindrance to accessing mental health services; (4) The role of culture and religion in mental health services; and (5) Lack of government concern about mental health services. Conclusion This study identified important factors related to mental health services in Northwest Ethiopia, from the perspectives of health professionals. Our findings highlighted that the government health agenda needs to prioritize mental health services. The role of religious and cultural healing places in the help-seeking pathway should be given due consideration to ensure success in mental health services provision and utilization.

Treatment-seeking behavior and barriers to mental health service utilization for depressive symptoms and hazardous drinking: The role of religious and traditional healers in mental healthcare of Northwest Ethiopia

“…Interestingly, religious places were reported to be the most helpful source of treatment (39.5%) for depressive symptoms. A preference for religious and traditional healers over healthcare facilities was also reported in our previous qualitative study where seeking treatment from healthcare facilities was the last resort in the treatment-seeking pathway (Mekonen et al, 2022 ). Previous studies in Ethiopia reported that patients were comfortable taking treatments from healthcare facilities alongside religious/traditional healers (Baheretibeb et al, 2021 ).…”

“…As such, mental health services coverage could be increased by utilizing the existing help-seeking pathway of religious/traditional healers. Basic mental health training for religious leaders and traditional healers could also help increase referrals to health facilities (Mekonen et al, 2022 ).…”

“…In addition to the low mental health literacy, people may opt not to seek mental health services due to the stigma and discrimination attached to receiving mental illness diagnoses (Corrigan, 2004 ; Mekonen et al, 2022 ). This is also indicated in our study that seeking treatment for depressive symptoms was three-fold more likely in participants who had positive attitudes about mental illness (adj OR = 2.84) and participants who reported low internalized stigma of depression (adj OR = 3.00).…”

A systematic review of reviews on the advantages of mHealth utilization in mental health services: A viable option for large populations in low-resource settings

“…These challenges stem from a scarcity of resources, an absence of standardized tools for monitoring service quality, frail health systems and the complexities of diverse cultural environments (Lund, 2018 ; Galagali and Brooks, 2020 ). Furthermore, the challenges encompass the absence of governmental prioritization of mental health, extensive distances to reach treatment facilities, inadequate availability of trained personnel and the prevailing perception that mental illness is non-life-threatening, resulting in a diminished emphasis on mental health services (Mekonen et al, 2022 ).…”

Prevalence and determinants of postpartum depression among adolescent and adult mothers in Northwest Ethiopia

“…Many people in Africa suffer from mental health conditions but do not have access to the necessary care and resources to address their conditions (Nicholas et al, 2022). In Ethiopia, obstacles to the provision and use of mental health services include low mental health literacy, social stigma associated with mental illness, limited government attention (Mekonen et al, 2022), and shortage of mental health providers and poor access to mental health services (Yitbarek et al, 2021). The failure to diagnose and treat maternal depression can lead to chronic adverse outcomes for children, including malnutrition, poor mental, psychosocial, and physical health, premature death, and violates their basic rights (Mokwena, 2021).…”