Demand and access to mental health services: a qualitative formative study in Nepal

Abstract

Nepal is experiencing a significant ‘treatment gap’ in mental health care. People with mental disorders do not always receive appropriate treatment due to a range of structural and individual issues, including stigma and poverty. The PRIME (Programme for Improving Mental Health Care) programme has developed a mental health care plan to address this issue in Nepal and 4 other low and middle income countries. This study aims to inform the development of this comprehensive care plan by investigating the perceptions of stakeholders at different levels of the care system in the district of Chitwan in southern Nepal: health professionals, lay workers and community members. It focuses specifically on issues of demand and access to care, and aims to identify barriers and potential solutions for reaching people with priority mental disorders. This qualitative study consisted of 33 informant interviews and focus group discussions (83 participants in 9 groups) at community and health facility levels. Data were analysed using a framework analysis approach. There is a policy brief on this research This research is supported by the Department for International Development’s Programme for Improving Mental Health Care (PRIME) which is led by University of Cape Town