Aug 2026· Indian Journal of Psychiatry· Vol 68, pp. S436-S444· 0 citations· 36 references
TL;DR
DSCs significantly contribute to the treatment gap and aggressive and sustained public health measures/campaigns need to be incorporated to effectively tackle DSCs.
Abstract
In the context of public mental healthcare delivery in India, in contrast to the often highlighted challenges related to the supply side, the demand-side challenges (DSC) are rarely examined systematically.
To assess the DSC in patients with psychiatric disorders and their caregivers in a rural South Indian community.
This study was conducted as part of a larger implementation research in which all adults in a predefined catchment area were screened for mental disorders, followed by confirmation of diagnosis by mental health professionals. The patients were counseled about (a) the need to start/resume/continue treatment and (b) the availability of services at the nearest health facility. DSC were evaluated by a targeted question to the patient/family members on reasons for not accessing/continuing treatment.
Among the 268 confirmed treatment-naïve patients at baseline, only 6 (0.02%) could be convinced to contact a treatment facility within the next 8 weeks. Regarding DSCs, for all disorders put together, factors related to the illnesses themselves (aggression, hostility, intoxication with substances, absence of insight, and, in instances specific to substance use, lack of motivation to stop its use were present in almost all (98.7%) patients. Lack of perceived dysfunction/disability (42.3%) and poor awareness (24.9%) formed the other two common factors. Disorder-wise breakup showed that poor awareness was predominant in Common Mental Disorders (CMDs; 60%). Illness-related factors predominated in Severe Mental Disorders (SMDs; 66.6%) and Substance Use Disorders (SUDs; 98.7%). Lack of perceived dysfunction mattered next for SUDs (42.3%), followed by poor awareness (24.9%). For SMDs, family support-related factors (47.9%) ranked second, followed by poor awareness (25%).
DSCs significantly contribute to the treatment gap. Merely making the treatment available and accessible will not be sufficient for people to accept it. Aggressive and sustained public health measures/campaigns need to be incorporated to effectively tackle DSCs.
Key challenges identified included the absence of integrated treatment for comorbid mental health conditions, frequent relapses, lack of culturally adaptive interventions, limited innovation in treatment approaches, minimal family involvement, and absence of individualized treatment planning.
F. Ahmed, Djamil A Malik· Foundation University Journa...· 0 citations
BACKGROUND
Mental health and psychosocial well-being remain critically underprioritized in Central Africa, a region characterized by persistent conflict, displacement, poverty, and fragile health systems. This narrative review synthesizes evidence on mental health and psychosocial support (MHPSS) needs across Central Africa, identifies gaps, and informs policy directions.
METHODS
A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted (January 2010-December 2025) using keywords related to mental health, psychosocial support, and Central African countries. Nine articles met the inclusion criteria and were synthesized narratively.
RESULTS
The literature reveals consistently elevated prevalence of post-traumatic stress disorder (> 30% among internally displaced persons in the Democratic Republic of Congo), depression, and anxiety among conflict-affected populations. Mental health services remain grossly inadequate, concentrated in urban areas, underfunded, and poorly integrated into primary healthcare. Key barriers include insufficient infrastructure, scarcity of trained professionals, pervasive stigma, and logistical challenges. Community-based and task-shifting approaches demonstrate promise, yet sustainability remains constrained. Cultural contexts significantly influence help-seeking behaviors.
CONCLUSION
Addressing MHPSS needs in Central Africa requires multi-sectoral strategies that integrate mental health into broader public health agendas, strengthen community-based interventions, build local capacity, and foster partnerships. Context-specific research and policy reforms are essential.
E. Amin, P. T. N. Mvilongo, Asonglefac Bonita Fonkem et al.· Discover Mental Health· 0 citations
Mental health challenges among young adults is an increasing public health problem at the global level. Young adults living in rural settings are a group at a higher risk as there are multiple barriers to seeking psychological services. There is a deficiency in the number of professionals available, a shortage of proper healthcare infrastructure, geographic barriers, and the socio-cultural stigma that is present among rural youth. The combination of these factors has led to a significant rural-urban difference in mental healthcare accessibility and in the level of unmet mental health needs, resulting in a long-term negative outcome.
Tele-health service is believed to fill the service gap as it enables remote provision of psychological counselling, psychiatric consultations, and other forms of digital therapeutic intervention. The current conceptual review addresses issues pertaining to why Tele-health is expected to be a potential solution to the existing gap in delivering mental health service to the rural young adult. It relies on two theoretical models- Technology Acceptance Model (Davis, 1989) and Diffusion of Innovations Theory (Rogers, 2003)- that try to predict the adoption and usage of these digital mental health applications by rural dwellers.
In this review, three major concepts were investigated; Mental health among young adults, access to rural health care, and Tele-health service provision. Potential benefits of Tele-health services were assessed based on factors such as improved access, cost reduction, enhancement in privacy, and high adoption among young adults. Conversely, the barriers such as the digital divide, data privacy concerns and limitations of virtual face-to-face interaction in therapeutic provision are discussed. The review concludes that tele-health may significantly bridge mental health disparity for the rural young adult population; however, the success of these services depends on substantial investment in digital infrastructures, creation of favorable policy environments and ongoing interdisciplinary research on accessibility and efficacy.
Christy Ugo Peters· World Journal of Advanced Re...· 0 citations
The rural young adults between 18 and 25 years are still among the most underserved groups in the systems of global mental health with compounded stigma, provider shortages, geographic isolation, and limited digital infrastructure. The literature review will focus on the importance of telehealth as a tool of increasing access to mental health among this population based on five empirical studies published between the years 2020 and 2024. The study was a synthesis of evidence on qualitative, quantitative, mixed-method, and conceptual research studies carried out in the United States, Australia, and other global locations using a structured review methodology.
The evidence points to the constant moderate to high effectiveness of telehealth interventions in the form of video consultations, smartphone-based applications, computerized cognitive behavioral therapy (cCBT), and telepsychiatry in terms of minimizing the level of depressive symptoms and improving access to services among rural young adults. Telehealth was discovered to minimize transportation obstacles, enhance adherence to appointments as well as greater parental involvement where applicable. Nevertheless, as the evidence also indicates, there are essential constraints as telehealth itself is not enough when dealing with people with complex neurodevelopmental models. The lack of effective digital connectivity weakens the coverage of services, and the relationship aspects of therapy are more problematic to build in remote modalities. Irrespective of the modality of delivery, stigma, lack of mental health literacy, and confidentiality issues continue to be key impediments to help-seeking among this group of people.
It is concluded that telehealth has a high potential as a supplementary approach in the framework of a blended care model of rural young adults but should be supported by structural investments in digital infrastructure, workforce training, and anti-stigmatization efforts.
Christy Ugo Peters· World Journal of Advanced Re...· 0 citations
Mental disorders represent a growing global burden, with particularly large treatment gaps in low- and middle-income countries such as Brazil. Educational initiatives like Mental Health First Aid (MHFA) seek to improve mental health literacy and reduce stigma among lay populations. This pilot study evaluated the feasibility, applicability, and preliminary findings of a Brazilian-adapted MHFA-informed program based on culturally adapted Brazilian MHFA guidelines. A total of 124 employees from three workplaces (two non-profit organizations and one private company) were allocated into intervention and control groups according to institutional operational feasibility, participant registration order, and workplace scheduling demands. The Brazilian-adapted MHFA-informed program consisted of five 1-hour sessions covering depression, psychosis, suicide, trauma, and alcohol-related problems; the control group received Ministry of Health educational materials. Outcomes included attitudes toward mental illness (EMO-56) and perceived stigma (PDDQ), assessed at baseline (T1) and post-intervention (T2). No significant group differences were observed, although both groups showed improvements over time, particularly in the Policy and Structural Assistance dimension (p<0.001). Participants with higher baseline knowledge demonstrated more pronounced improvements over time, and those with self-reported mental illness exhibited more positive attitudes and less stigma. These findings support the feasibility and cultural applicability of a Brazilian-adapted MHFA-informed program in workplace settings. Although limited by sample size and participant attrition, the study highlights the potential relevance of culturally adapted psychoeducational interventions for promoting mental health knowledge and reducing stigma in Brazilian contexts. Future controlled studies with larger samples are needed to further evaluate these approaches.
K. N. Mendes, S. S. Requena, A. Loch et al.· Frontiers in Psychiatry· 0 citations
Mental health is an essential component of overall well-being, influencing how individuals think, feel, cope with stress, and interact with others. Despite increasing global awareness, mental health stigma continues to remain a major public health concern, particularly in low- and middle-income countries, where misconceptions, discrimination, and limited access to care discourage individuals from seeking professional support. This study aimed to assess mental health awareness and stigma among residents of Shankharapur Municipality, Kathmandu, Nepal, and to identify barriers to mental health care as well as possible strategies to reduce stigma within the community. A cross-sectional descriptive mixedmethod research design was employed among 105 respondents selected through simple random sampling from Ward No. 6. Data were collected through structured questionnaires and face-to-face interviews and analyzed using descriptive statistics and thematic analysis. The findings revealed that respondents generally possessed a good level of mental health awareness, with many recognizing the importance of mental health and acknowledging that mental illness can affect anyone. However, stigmatizing attitudes and misconceptions remained prevalent, including beliefs that mental illness is associated with danger, personal weakness, and shame. Major barriers to accessing mental health support included lack of awareness, social stigma, fear of judgment, family influence, and poor communication. Despite these challenges, respondents expressed positive attitudes toward recovery and social inclusion of individuals with mental illness. The study concludes that although mental health awareness is gradually improving, stigma remains a significant barrier to help-seeking behavior. Therefore, community-based awareness programs, mental health education, counseling services, and culturally sensitive anti-stigma interventions are essential to improve mental health outcomes and promote a supportive social environment.
A. Shrestha· Aadim Journal of Multidiscip...· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
