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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

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Düşük ve orta gelirli ülkelerde ruh sağlığı hizmetine erişim engellerinin incelenmesi: sistematik derleme ve tematik sentez (Examining barriers to accessing mental health services in low- and middle-income countries: a systematic review and thematic synthesis)

EXPLORING BARRIERS TO MENTAL HEALTHCARE ACCESS IN LOW- AND MIDDLE- INCOME COUNTRIES (LMICS): A SYSTEMATIC REVIEW AND THEMATIC SYNTHESIS.

The barriers patients face in accessing mental health services in low- and middle-income countries operate in interconnected ways at structural, economic, and sociocultural levels, delaying care and perpetuating the treatment gap.

The aim was to examine the barriers patients face when accessing mental health services in low- and middle-income countries (LMICs) through qualitative research. In this systematic review, conducted in accordance with ENTREQ guidance, MEDLINE, Embase, CINAHL, and Web of Science were searched using terms related to help-seeking behaviors, barriers, mental health services, and accessibility, together with filters for LMICs and qualitative research. Screening was performed by two independent reviewers using predefined criteria, quality was assessed using CASP, and data were analyzed through thematic synthesis in NVivo. Of the 3,116 studies identified, seven were included; these studies involved 151 participants from six countries (two studies from India, and one each from Bangladesh, Uganda, The Gambia, Rwanda, and Nigeria) and covered rural and urban communities, primary care, outpatient clinics, and specialist, tertiary care, and referral hospitals. Three analytical themes were developed, each supported by three subthemes. The first theme concerned structural and material constraints shaping access (economic constraints and service affordability; health system capacity, quality, and organization; and geographical and physical barriers). The second theme concerned cultural meanings of mental illness and their incompatibility with biomedical care (beliefs and understandings about illness and treatment; cultural and religious explanatory frameworks and alternative care; and pluralistic and delayed help-seeking pathways). The third theme concerned how help-seeking is regulated through stigma, family, and social roles (stigma, shame, and fear; family influence, support, and control; and social positioning and role-related constraints). The authors state that improving access requires more than service provision: it calls for culturally sensitive care, stigma reduction, capacity strengthening, and integration with primary care. They emphasize that responses should account for lived experiences and local contexts rather than focusing solely on the supply of services.

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