| dc.description.abstract | Background: Although children and adolescents in low and middle-income countries (LMICs) have been affected by the mental illnesses, most of them do not seek help or receive treatment. Uganda, a LIC, has been affected by wars, HIV/pandemic, malaria, and violence all of which increase burden of mental illness. However, only 1% of the Uganda health budget has been allocated to mental health and relatively little study has been conducted on health providers perceptions on child and adolescent mental health treatment seeking compared to other health topics. This study explored the barriers and facilitators for accessing mental health services from the perspective of health service providers in Mbale, Uganda.
Methodology: This was a qualitative study using key informant interview with 15 health service providers working in Mbale, using the key-informant interview (KII) guide. The data were then transcribed and analyzed using thematic analysis.
Results: According to health service providers, children and adolescent’s access to mental health services can be hindered by both health system barriers (absence of dedicated child and adolescent mental health (CAMH) services, lack of CAMH-trained personnel, limited supply of psychotropic medications in health facilities, lack of up-to-date mental health training opportunities to health staff, insufficient budget allocation for mental healthcare), and societal barriers (community stigma, discrimination and ignorance about mental illness, deep-rooted traditional beliefs and poor socio-economic condition of the community). On the other hand, facilitating factors suggested improving child and adolescent access to mental health services were community sensitization, expanding human, financial, and infrastructural resources and psychotropic medications dedicated to treating child mental illness, motivating and training on mental health to health staff, improved opportunities for professional growth, community insurance schemes, advocacy, and establishment of child and adolescent-friendly safe spaces.
Conclusion: Barriers and facilitating factors identified in this study can be helpful for decision-makers to develop policies in favor of children and adolescents with mental illness and to adopt various strategies to reduce the child and adolescent mental health treatment gap.
Keywords: child and adolescent mental health services (CAMHS), health staff perceptions, service access, barriers, facilitators, low- and middle-income countries (LMICs), Sub-Saharan Africa, Uganda, Mbale district | |