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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





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