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Table 2 Showing barriers to access mental health care services cited by study participants from the 3 countries

From: 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

Barrier Nepal Liberia Uganda
Lack of awareness
Economic burden
Delay in family decision for seeking care   
Myths and misconception regarding mental health problems  
Social stigma and discrimination
Lack of social support   
Unwillingness of patients to take prescribed medicine (e.g. due to fear of side effects, severity of illness, and lack of support at home)   
Low regard of the mentally ill: negligence of caregivers/family members/community members (considered useless)   
Recurrence of the illness   
Inaccessible mental health services due to geographical constraints
Negative attitudes of health workers
Lack of patient follow-up   
Lack of mental health medicines,
Change of service providers   
Inadequate mental health specialists
Overcrowding at the health facilities   
Long distances to the health centers  
Fear of PLWSMDE by other patients and caregivers at the health centre   
Traditional beliefs about mental illness (witchcraft, curses, incurable), leading to preference for traditional remedies  
Lack of awareness
Economic burden
Lower cost of services and more flexible terms offered by traditional healers   
Unwillingness of some patients to go the health centers, sometimes due to lack of insight