The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index.
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]
In the citing paper
“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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Cites
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
Cited by
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Treatment rates for alcohol use disorders: A systematic review and meta-analysis
Mekonen, T., Chan, G. C. K., Connor, J., Hall, W., Hides, L., & Leung, J. (2021) · Addiction · doi:10.1111/add.15357 · Cited by 207
Estimating the global treatment rates for depression: a systematic review and meta-analysis
Mekonen, T., Chan, G. C. K., Connor, J. P., Hides, L., & Leung, J. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.09.038 · Cited by 137
Treatment gap, help-seeking, stigma and magnitude of alcohol use disorder in rural Ethiopia
Zewdu, S., Hanlon, C., Fekadu, A., Medhin, G., & Teferra, S. (2019) · Substance Abuse Treatment, Prevention, and Policy · doi:10.1186/s13011-019-0192-7 · Cited by 110
Jordans, M. J. D., Luitel, N. P., Garman, E., Kohrt, B. A., Rathod, S. D., Shrestha, P., Komproe, I. H., Lund, C., & Patel, V. (2019) · British Journal of Psychiatry · doi:10.1192/bjp.2018.300 · Cited by 89
Self-citationKohrt, B. A., Jordans, M. J. D., Turner, E. L., Rai, S., Gurung, D., Dhakal, M., Bhardwaj, A., Lamichhane, J., Singla, D. R., Lund, C., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.31475 · Cited by 90
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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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