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Treatment gap and barriers for mental health care: A cross-sectional community survey in Nepal
Open accessAbstract
CONTEXT: There is limited research on the gap between the burden of mental disorders and treatment use in low- and middle-income countries. OBJECTIVES: The aim of this study was to assess the treatment gap among adults with depressive disorder (DD) and alcohol use disorder (AUD) and to examine possible barriers to initiation and continuation of mental health treatment in Nepal. METHODS: A three-stage sampling technique was used in the study to select 1,983 adults from 10 Village Development Committees (VDCs) of Chitwan district. Presence of DD and AUD were identified with validated versions of the Patient Health Questionnaire (PHQ-9) and Alcohol Use Disorder Identification Test (AUDIT). Barriers to care were assessed with the Barriers to Access to Care Evaluation (BACE). RESULTS: In this sample, 11.2% (N = 228) and 5.0% (N = 96) screened positive for DD and AUD respectively. Among those scoring above clinical cut-off thresholds, few had received treatment from any providers; 8.1% for DD and 5.1% for AUD in the past 12 months, and only 1.8% (DD) and 1.3% (AUD) sought treatment from primary health care facilities. The major reported barriers to treatment were lacking financial means to afford care, fear of being perceived as "weak" for having mental health problems, fear of being perceived as "crazy" and being too unwell to ask for help. Barriers to care did not differ based on demographic characteristics such as age, sex, marital status, education, or caste/ethnicity. CONCLUSIONS: With more than 90% of the respondents with DD or AUD not participating in treatment, it is crucial to identify avenues to promote help seeking and uptake of treatment. Given that demographic characteristics did not influence barriers to care, it may be possible to pursue general population-wide approaches to promoting service use.
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“This gap is particularly marked in low-income and lower-middle-income countries (9, 11, 12).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [12]
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“Despite this, AUD is often not detected in health care settings, which contributes to a wide treatment gap.”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [12]
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No health without mental health
Prince, M. J., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., & Rahman, A. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61238-0 · Cited by 4,028
(2004) · JAMA · doi:10.1001/jama.291.21.2581 · Cited by 3,448 · cited 1×
“The treatment gap reported in this sample was smaller than in China [52], Korea [53] and North India [54], whereas it was larger than that found in a study conducted in 8 developed and 6 less developed countries between 2001 to 2003 [26].”
ResultGrant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., Pickering, R. P., & Kaplan, K. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.8.807 · Cited by 2,889
Challenging the public stigma of mental illness: a meta-analysis of outcome studies
Corrigan, P. W., Morris, S. B., Michaels, P. J., Rafacz, J. D., & Rüsch, N. (2012) · Psychiatric Services · doi:10.1176/appi.ps.201100529 · Cited by 1,680
Hawton, K., & van Heeringen, K. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60372-x · Cited by 1,671
Treatment gap in mental health care.
Abramowitz, M. Z., Greenberg, D., & Levav, I. (2008) · PubMed · Cited by 1,483
The treatment gap in mental health care.
(2004) · Europe PMC (PubMed Central) · Cited by 1,419
Poverty and common mental disorders in low and middle income countries: A systematic review
Lund, C., Breen, A., Flisher, A. J., Kakuma, R., Corrigall, J., Joska, J. A., Swartz, L., & Patel, V. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.04.027 · Cited by 1,375
Gilbody, S., Richards, D., Brealey, S., & Hewitt, C. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0333-y · Cited by 1,290
Undertreatment of people with major depressive disorder in 21 countries
Thornicroft, G., Chatterji, S., Evans-Lacko, S., Gruber, M., Sampson, N., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Andrade, L., Borges, G., et al. (2017) · British Journal of Psychiatry · doi:10.1192/bjp.bp.116.188078 · Cited by 1,121
Barriers to improvement of mental health services in low-income and middle-income countries
Saraceno, B., van Ommeren, M., Batniji, R., Cohen, A., Gureje, O., Mahoney, J., Sridhar, D., & Underhill, C. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61263-x · Cited by 1,088
Depression and cardiac mortality: results from a community-based longitudinal study.
Penninx, B., Beekman, A., Honig, A., Deeg, D., Schoevers, R., van Eijk, J., & van Tilburg, W. V. (2001) · Archives of General Psychiatry · doi:10.1001/archpsyc.58.3.221 · Cited by 983
McWilliams, L. A., Cox, B. J., & Enns, M. W. (2003) · Pain · doi:10.1016/s0304-3959(03)00301-4 · Cited by 951
Mortality of patients with mood disorders: follow-up over 34–38 years
Angst, F., Stassen, H. H., Clayton, P. J., & Angst, J. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(01)00377-9 · Cited by 881
Excess mortality in depression: a meta-analysis of community studies
Cuijpers, P. J., & Smit, F. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(01)00413-x · Cited by 798
Patel, V., Weiss, H. A., Chowdhary, N., Naik, S., Pednekar, S., Chatterjee, S., De Silva, M. J., Bhat, B., Araya, R., King, M., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)61508-5 · Cited by 752
Scale up of services for mental health in low-income and middle-income countries
Eaton, J., McCay, L., Semrau, M., Chatterjee, S., Baingana, F., Araya, R., Ntulo, C., Thornicroft, G., & Saxena, S. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60891-x · Cited by 698
Lund, C., Tomlinson, M., De Silva, M., Fekadu, A., Shidhaye, R., Jordans, M., Petersen, I., Bhana, A., Kigozi, F., Prince, M., et al. (2012) · PLoS Medicine · doi:10.1371/journal.pmed.1001359 · Cited by 584
Self-citationvan Ginneken, N., Tharyan, P., Lewin, S., Rao, G. N., Meera, S., Pian, J., Chandrashekar, S., & Patel, V. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009149.pub2 · Cited by 575
Folsom, D. P., Hawthorne, W. B., Lindamer, L. A., Gilmer, T., Bailey, A. L., Golshan, S., Garcia, P., Unützer, J., Hough, R. L., & Jeste, D. V. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.2.370 · Cited by 551
Jané‐Llopis, E., & MATYTSINA, I. (2006) · Drug and Alcohol Review · doi:10.1080/09595230600944461 · Cited by 496
Health service coverage and its evaluation.
Tanahashi, T. (1978) · PubMed · Cited by 485
SAUNDERS, J. B., AASLAND, O. G., AMUNDSEN, A., & GRANT, M. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb00822.x · Cited by 480
Sareen, J., Jagdeo, A., Cox, B. J., Clara, I., ten Have, M., Belik, S.-L., de Graaf, R., & Stein, M. B. (2007) · Psychiatric Services · doi:10.1176/ps.2007.58.3.357 · Cited by 470
Reducing the treatment gap for mental disorders: a WPA survey
PATEL, V., MAJ, M., FLISHER, A. J., DE SILVA, M. J., KOSCHORKE, M., PRINCE, M., WPA Zonal and Member Society Representatives, Tempier, R., Riba, M., Sanchez, M., et al. (2010) · World Psychiatry · doi:10.1002/j.2051-5545.2010.tb00305.x · Cited by 420
van Ommeren, M., Sharma, B., Thapa, S. B., Makaju, R., Prasain, D., Bhattarai, R., & de Jong, J. T. V. M. (1999) · Transcultural Psychiatry · doi:10.1177/136346159903600304 · Cited by 338
Chatterjee, S., Naik, S., John, S., Dabholkar, H., Balaji, M., Koschorke, M., Varghese, M., THARA, R., Weiss, H. A., Williams, P. R., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(13)62629-x · Cited by 322
Clement, S., Brohan, E., Jeffery, D., Henderson, C., Hatch, S. L., & Thornicroft, G. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-36 · Cited by 314
Kohrt, B. A., & Hruschka, D. J. (2010) · Culture Medicine and Psychiatry · doi:10.1007/s11013-010-9170-2 · Cited by 303
Self-citationShen, Y., Zhang, M., Huang, Y., He, Y., Liu, Z., Cheng, H. G., Tsang, A., Lee, S., & Kessler, R. C. (2005) · Psychological Medicine · doi:10.1017/s0033291705006367 · Cited by 300
Kohrt, B. A., Luitel, N. P., Acharya, P., & Jordans, M. J. D. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0768-y · Cited by 250
Self-citationLuitel, N. P., Jordans, M. J. D., Adhikari, A., Upadhaya, N., Hanlon, C., Lund, C., & Komproe, I. H. (2015) · Conflict and Health · doi:10.1186/s13031-014-0030-5 · Cited by 233
Self-citationLora, A., Kohn, R., Levav, I., McBain, R. K., Morris, J. E., & Saxena, S. (2011) · Bulletin of the World Health Organization · doi:10.2471/blt.11.089284 · Cited by 209
Psychological distress among displaced persons during an armed conflict in Nepal
Thapa, S. B., & Hauff, E. (2005) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-005-0943-9 · Cited by 206
Stigma and discrimination as a barrier to mental health service utilization in India
Shidhaye, R., & Kermode, M. (2013) · International Health · doi:10.1093/inthealth/ihs011 · Cited by 191
Poor mental health influences risk and duration of unemployment: a prospective study
Butterworth, P., Leach, L., Pirkis, J., & Kelaher, M. (2011) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-011-0409-1 · Cited by 190
Navigating diagnoses: understanding mind-body relations, mental health, and stigma in Nepal
Kohrt, B. A., & Harper, I. (2008) · Culture, Medicine, and Psychiatry · doi:10.1007/s11013-008-9110-6 · Cited by 185
Self-citationConflict and mental health: a cross-sectional epidemiological study in Nepal
Luitel, N. P., Jordans, M. J. D., Sapkota, R. P., Tol, W. A., Kohrt, B. A., Thapa, S. B., Komproe, I. H., & Sharma, B. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0539-0 · Cited by 166
Self-citationJefferis, B. J. M. H., Nazareth, I., Marston, L., Moreno‐Küstner, B., Bellón, J. Á., Švab, I., Rotar, D., Geerlings, M. I., Xavier, M., Gonçalves‐Pereira, M., et al. (2011) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.09.029 · Cited by 148
Reasons and determinants for not receiving treatment for common mental disorders
van Beljouw, I., Verhaak, P., Prins, M., Cuijpers, P., Penninx, B., & Bensing, J. (2010) · Psychiatric Services · doi:10.1176/ps.2010.61.3.250 · Cited by 143
Political violence and mental health: A multi-disciplinary review of the literature on Nepal
Tol, W. A., Kohrt, B. A., Jordans, M. J. D., Thapa, S. B., Pettigrew, J., Upadhaya, N., & de Jong, J. T. V. M. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2009.09.037 · Cited by 135
Self-citationPolitical violence and mental health in Nepal: prospective study
Kohrt, B. A., Hruschka, D. J., Worthman, C. M., Kunz, R. D., Baldwin, J. L., Upadhaya, N., Acharya, N. R., Koirala, S., Thapa, S. B., Tol, W. A., et al. (2012) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.111.096222 · Cited by 123
Self-citationEstimating the coverage of mental health programmes: a systematic review
Silva, M. J. D., Lee, L., Fuhr, D. C., Rathod, S. D., Chisholm, D., Schellenberg, J., & Patel, V. (2014) · International Journal of Epidemiology · doi:10.1093/ije/dyt191 · Cited by 111
Self-citationPerceived need for alcohol, drug, and mental health treatment
Edlund, M. J., Unützer, J., & Curran, G. M. (2006) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-006-0047-1 · Cited by 109
Cross-sectional study of depression and help-seeking in Uttarakhand, North India
Mathias, K. R., Goicolea, I., Kermode, M., Singh, L., Shidhaye, R. R., & Sebastiån, M. S. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008992 · Cited by 109
Evaluation of district mental healthcare plans: The PRIME consortium methodology
De Silva, M. J., Rathod, S. D., Hanlon, C., Breuer, E., Chisholm, D., Fekadu, A., Jordans, M., Kigozi, F., Petersen, I., Shidhaye, R., et al. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.153858 · Cited by 106
Self-citationRathod, S. D., De Silva, M. J., Ssebunnya, J., Breuer, E., Murhar, V., Luitel, N. P., Medhin, G., Kigozi, F., Shidhaye, R., Fekadu, A., et al. (2016) · PLOS ONE · doi:10.1371/journal.pone.0162038 · Cited by 103
Self-citationProcesses of Internal and International Migration from Chitwan, Nepal
Bohra, P., & Massey, D. S. (2009) · International Migration Review · doi:10.1111/j.1747-7379.2009.00779.x · Cited by 101
Dockery, L., Jeffery, D., Schauman, O., Williams, P. R., Farrelly, S. E., Bonnington, O., Gabbidon, J., Lassman, F., SZMUKLER, G. I., Thornicroft, G., et al. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.05.044 · Cited by 96
Pradhan, B., Chappuis, F., Baral, D., Karki, P., Rijal, S., Hadengue, A., & Gache, P. (2012) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/1747-597x-7-42 · Cited by 87
Demand and access to mental health services: a qualitative formative study in Nepal
Brenman, N. F., Luitel, N. P., Mall, S., & Jordans, M. J. D. (2014) · BMC International Health and Human Rights · doi:10.1186/1472-698x-14-22 · Cited by 83
Self-citationSociodemographic disparities associated with perceived causes of unmet need for mental health care.
Alang, S. (2015) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000113 · Cited by 80
Jack-Ide, I. O., & Uys, L. R. (2013) · Pan African Medical Journal · doi:10.11604/pamj.2013.14.159.1970 · Cited by 74
Mental health service use in a nationwide sample of Korean adults
Cho, S. J., Lee, J., Hong, J. P., Lee, H. B., Cho, M. J., & Hahm, B. (2009) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-009-0015-7 · Cited by 70
Kohrt, B. A., & Worthman, C. M. (2009) · CNS Neuroscience & Therapeutics · doi:10.1111/j.1755-5949.2009.00096.x · Cited by 64
Self-citationLuitel, N. P., Jordans, M. J. D., Murphy, A., Roberts, B., & McCambridge, J. (2013) · Alcohol and Alcoholism · doi:10.1093/alcalc/agt009 · Cited by 61
Self-citationPhilips, M., & Derderian, K. (2015) · Conflict and Health · doi:10.1186/s13031-015-0039-4 · Cited by 35
Silva, L., da Silva, P. F. R., Gadelha, A., Clement, S., Thornicroft, G., Mari, J. D. J., & Brietzke, E. M. (2013) · Trends in Psychiatry and Psychotherapy · doi:10.1590/2237-6089-2013-0022 · Cited by 12
An Evaluation of Nepal's Free Health Care Schemes: Evidence from a Quasi-Experimental DesignPreprint
Adhikari, S. R. (2013) · SSRN Electronic Journal · doi:10.2139/ssrn.2289344 · Cited by 9
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Metadata
- Authors
- Luitel, N. P., Jordans, M. J. D., Kohrt, B. A., Rathod, S. D., & Komproe, I. H.
- Affiliations
- King's College London (GB)
- Duke University (US)
- London School of Hygiene & Tropical Medicine (GB)
- Utrecht University (NL)
- Corresponding author
- Luitel, Nagendra P.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-08-17
- Volume
- 12
- Issue
- 8
- Pages
- e0183223
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5560728
- OpenAlex
- W2746688446
- Cited by
- 165
- References
- 59
- Citations by year
- 2026: 12 · 2025: 21 · 2024: 13 · 2023: 28 · 2022: 21 · 2021: 21 · 2020: 29 · 2019: 15 · 2018: 5
- FWCI
- 19.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- Government of the United Kingdom
- National Institute of Mental Health (K01MH104310)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- treatment gap, barriers to mental health care, depressive disorders, alcoholism, help-seeking, mental health service utilization, primary care, stigma, financial barriers, Nepal, Chitwan district
- MeSH terms
- Adolescent, Adult, Cross-Sectional Studies, Female, Humans, Male, Mental Health Services, Middle Aged, Nepal, Young Adult
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