Barriers | Recommended strategies | Specific interventions |
---|---|---|
Theme I: Availability | ||
Absence of mental health services | Making the service locally available | Integration to primary care |
Absence of psychotropic medications | Ensure availability of medications | Include psychotropic medications in the drug list |
Theme II: Affordability and accessibility | ||
Inability to cover treatment related costs | Providing cheaper treatment | Financial support to āpoorest of the poorā |
Subsidising mental health treatment | ||
Longer distance travelled to access services | Establishing the service within reach | Facilitate emergency transportation |
Plan outreach mental health service | ||
Indirect expenses of seeking care | Ā | Interventions to improve household income |
Theme III: Acceptability and adequacy | ||
Causal attribution: attribution to some evil spirits | Raise awareness | Involving HEWs in raising awareness and initiating discussions |
Engaging religious leaders in awareness raising | ||
Lack of trust in modern medication | Raise awareness | Involving service users who recovered |
Telling success stories of those treated | ||
Lack of awareness (the belief that mental illnesses are not curable) | Raise awareness | Engage traditional healers in educating the community |
Amplify success stories from treatment | ||
Engage service users who recovered in assisting HEWs in their awareness raising endeavours | ||
High regard given to traditional healing | Raise awareness | Train traditional healers on detection of core symptoms of mental disorders |
Create referral linkage framework | ||
Work with church leaders | ||
Mainstream mental health contents in community conversations | ||
Concerns about quality of the service | Supervision | Supportive supervision by psychiatric nurses |
Telephone consultations |