title: Help-seeking behaviour, barriers to care and experiences of care among persons with depression in Eastern Cape, South Africa.
abstract: BACKGROUND
  Little is known about the help-seeking behaviour and barriers to care among people with depression in poor resource settings in Sub-Saharan Africa.
  
  
  METHODS
  This is a cross-sectional population-based study including 977 persons aged 18-40 living in the Eastern Cape Province in South Africa. The prevalence of depression was investigated with the help of a questionnaire (the Mini International Neuropsychiatric Interview). Several socio-economic variables, statements on help-seeking and perceptions of earlier mental health care were included. Data collection was performed from March to July 2012.
  
  
  RESULTS
  The prevalence of depression was 31.4%. People aged 18-29 and those with no or low incomes were less likely to seek help. Promotive factors for help-seeking included having social support and tuberculosis comorbidity. Of all people with depression in this sample, 57% did not seek health care at all even though they felt they needed it. Of the variety of barriers identified, those of most significance were related to stigma, lack of knowledge of their own illness and its treatability as well as financial constraints.
  
  
  CONCLUSIONS
  Recall bias may be present and the people identified with depression were asked if they ever felt so emotionally troubled that they felt they should seek help; however, we do not know if they had depression at the time they referred to.
  
  
  CONCLUSIONS
  Depression is highly prevalent among young adults in the Eastern Cape Province, South Africa; however, many do not seek help. Health planners should increase mental health literacy in the communities and improve the competence of the health staff.
authors.affiliation: University of Gothenburg, Department of Public Health and Community Medicine, Social Medicine, Arvid Wallgrens backe 7, Floor 3, 40530 Gothenburg, Sweden. Electronic address: Lena.Andersson@socmed.gu.se.
authors.forename: Lena M C
authors.initials: LMC
authors.lastname: Andersson
authors.affiliation: School of Global Studies, University of Gothenburg, Sweden.
authors.forename: Isabell
authors.initials: I
authors.lastname: Schierenbeck
authors.affiliation: Department of Nursing Science, Nelson Mandela Metropolitan University, South Africa.
authors.forename: Johanita
authors.initials: J
authors.lastname: Strumpher
authors.affiliation: University of Gothenburg, Department of Public Health and Community Medicine, Social Medicine, Arvid Wallgrens backe 7, Floor 3, 40530 Gothenburg, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Krantz
authors.affiliation: Department of Nursing Science, Nelson Mandela Metropolitan University, South Africa.
authors.forename: Kegan
authors.initials: K
authors.lastname: Topper
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Backman
authors.affiliation: Department of Nursing Science, Nelson Mandela Metropolitan University, South Africa.
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Ricks
authors.affiliation: School of Clinical Care Sciences, Nelson Mandela Metropolitan University, South Africa.
authors.forename: Dalena
authors.initials: D
authors.lastname: Van Rooyen
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Barriers to care; Disability; Help-seeking behavior; Major depression; Right to health; South Africa