The barriers preventing effective treatment of South African patients with mental health problems

Trump, Lisa; Hugo, Charmaine

doi:10.4314/ajpsy.v9i4.30224

“…Despite evidence that pharmacotherapy and psychotherapeutic interventions are helpful for psychiatric disorders, there are numerous barriers that contribute to inadequate care (Trump and Hugo, 2006;Seedat et al, 2002). In a study investigating barriers to treatment in a nationally representative study in South Africa, a low perceived need for treatment (92.8%) was the single most influential factor for not seeking treatment.…”

mentioning

confidence: 98%

Knowledge of and Stigma Associated With Mental Disorders in a South African Community Sample

Sorsdahl

¹

,

Stein

²

2010

Journal of Nervous &Amp; Mental Disease

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The aim of this study was to assess the awareness of, attitudes toward, and stigma associated with psychiatric disorders among South Africans. A convenience sample of 1081 members of the general public participated in the study. One of 10 vignettes portraying different psychiatric disorders with subtle or obvious symptoms was presented to each respondent. Schizophrenia was reported as being the most representative of a psychiatric disorder and post-traumatic stress disorder as the least representative. Psychosocial stress was reported more frequently than medical etiologies as a possible cause of mental disorders. Seeking help from a health professional in the form of psychotherapy was often endorsed as an effective treatment option, whereas taking medication was rarely endorsed. Respondents held more stigmatizing attitudes toward patients with substance abuse and schizophrenia, whereas post-traumatic stress disorder was stigmatized significantly less than the other conditions. Further effort is required to educate the public about the psychobiological underpinnings of psychiatric disorders and about the value of effective treatments.

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“…A number of nationally representative studies in the developed world have investigated barriers to mental health treatment (24,31); however, fewer data are available from developing countries, such as South Africa (32,33). In South Africa, barriers to treatment have not been researched as extensively as in other countries; however, low levels of mental health literacy (34,35), poorly developed mental health services, a limited supply of mental health professionals and staff (36–39), and a reliance on traditional medicine have been noted as contributing factors (40).…”

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confidence: 99%

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Bruwer¹,

Sorsdahl²,

Harrison³

et al. 2011

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Objective This study used data from the South African Stress and Health Study (SASH) to examine both structural and attitudinal barriers to treatment initiation among South Africans with mental disorders and to investigate predictors of treatment dropout. Methods Face-to-face interviews were conducted with 4,315 adult South Africans living in households or hostel quarters. The interview included a core diagnostic assessment of past-12-month mental disorders and assessments of disorder severity, service use, and barriers to treatment. Multivariate logistic regression models were used to determine predictors of not seeking treatment in relation to disorder severity and sociodemographic characteristics, as well as factors that were predictive of premature treatment discontinuation by participants who had received mental health treatment in the previous 12 months. Predictors of dropout were identified by cross-tabulation and discrete-time survival analysis. Results Of the 4,315 adults, 729 (16.9% weighted) met criteria for a mental disorder in the past 12 months. Across all levels of severity, the most frequently cited reason for not seeking professional treatment was a low perceived need for treatment. Among those who recognized the need but did not access treatment during the past 12 months (7.2%), attitudinal barriers to treatment seeking were reported more commonly than structural barriers (100% and 34%, respectively). Of the 182 respondents who received treatment (25% weighted), 20% discontinued prematurely. Various factors, such as substance use disorders and absence of health insurance, increased the odds of treatment dropout. Conclusions Low rates of treatment seeking and high treatment dropout rates for common mental disorders among South Africans are a major concern. Public health efforts to improve treatment of mental disorders should consider the multiple influences on treatment initiation and discontinuation.

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“…A number of nationally representative studies in the developed world have investigated barriers to mental health treatment (24,31); however, fewer data are available from developing countries, such as South Africa (32,33). In South Africa, barriers to treatment have not been researched as extensively as in other countries; however, low levels of mental health literacy (34,35), poorly developed mental health services, a limited supply of mental health professionals and staff (36–39), and a reliance on traditional medicine have been noted as contributing factors (40).…”

mentioning

confidence: 99%

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Bruwer

¹

,

Sorsdahl²,

Harrison³

et al. 2011

Psychiatric Services

View full text Add to dashboard Cite

Objective This study used data from the South African Stress and Health Study (SASH) to examine both structural and attitudinal barriers to treatment initiation among South Africans with mental disorders and to investigate predictors of treatment dropout. Methods Face-to-face interviews were conducted with 4,315 adult South Africans living in households or hostel quarters. The interview included a core diagnostic assessment of past-12-month mental disorders and assessments of disorder severity, service use, and barriers to treatment. Multivariate logistic regression models were used to determine predictors of not seeking treatment in relation to disorder severity and sociodemographic characteristics, as well as factors that were predictive of premature treatment discontinuation by participants who had received mental health treatment in the previous 12 months. Predictors of dropout were identified by cross-tabulation and discrete-time survival analysis. Results Of the 4,315 adults, 729 (16.9% weighted) met criteria for a mental disorder in the past 12 months. Across all levels of severity, the most frequently cited reason for not seeking professional treatment was a low perceived need for treatment. Among those who recognized the need but did not access treatment during the past 12 months (7.2%), attitudinal barriers to treatment seeking were reported more commonly than structural barriers (100% and 34%, respectively). Of the 182 respondents who received treatment (25% weighted), 20% discontinued prematurely. Various factors, such as substance use disorders and absence of health insurance, increased the odds of treatment dropout. Conclusions Low rates of treatment seeking and high treatment dropout rates for common mental disorders among South Africans are a major concern. Public health efforts to improve treatment of mental disorders should consider the multiple influences on treatment initiation and discontinuation.

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The barriers preventing effective treatment of South African patients with mental health problems

Cited by 10 publications

References 6 publications

Knowledge of and Stigma Associated With Mental Disorders in a South African Community Sample

Knowledge of and Stigma Associated With Mental Disorders in a South African Community Sample

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

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