title: Barriers to mental health services utilization in the Niger Delta region of Nigeria: service users' perspectives.
abstract: BACKGROUND
  There is only one neuro-psychiatric hospital for over four million people in the Niger Delta region of Nigeria. Low-income groups in urban and rural areas who access care through public mental health clinics are at greater risk of not accessing the needed mental health care. This study aimed to explored barriers that prevent people from utilizing mental health services, and to identifies key factors to increase access and improved service delivery.
  
  
  METHODS
  A qualitative study was conducted among 20 service users attending the outpatient clinic of Rumuigbo neuropsychiatric hospital. Ten participants were caregivers and 10 were clients, both having accessed services for at least one year.
  
  
  RESULTS
  The mean age was 37.7 years, 60% were males, 40% were unemployed and only 15% had a regular monthly income, while 65% live in rural areas. Barriers observed in mental health services use were physical, financial and cultural. These include absence of service in rural communities, poor knowledge of mental health services, stigma, transportation problems, waiting time at the facility and cost of service.
  
  
  CONCLUSIONS
  Stigma remains a strong barrier to accessing mental health services, and extensive efforts need to be made to overcome ignorance and discrimination. Mental health services need to be provided throughout the health care system to enable people to access them locally and affordably, preventing the need to travel and promoting service uptake and treatment continuation.
authors.affiliation: Faculty of Nursing, Niger Delta University, Wilberforce Island Amassoma, Bayelsa State, Nigeria.
authors.forename: Izibeloko Omi
authors.initials: IO
authors.lastname: Jack-Ide
authors.forename: Leana
authors.initials: L
authors.lastname: Uys
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009549:Nigeria; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Barrier; Niger Delta; Nigeria; cultural beliefs; mental health education; mental health service; service utilization