title: Barriers to mental health service utilisation in Sudan - perspectives of carers and psychiatrists.
abstract: BACKGROUND
  In order to scale up mental health care nationally, barriers to health services utilisation need to be identified and addressed.
  
  
  OBJECTIVE
  The aim of this study was to identify barriers to mental health services utilization in Sudan from the perspectives of carer's of mentally ill patients and psychiatrists and to make recommendations to address the identified barriers.
  
  
  METHODS
  Mixed research methods were used in this cross sectional survey. The quantitative part was conducted with carers of mentally ill patients who were staying in Tijani Elmahi psychiatric hospital in Sudan, and the qualitative part was conducted with the psychiatric consultants in the country.
  
  
  RESULTS
  103 carers and six psychiatric consultants participated in the study. According to carers, the main barriers to utilisation of mental health services includes: the beliefs around mental illness, resorting to alternative treatments such as religious and traditional healers, centralization of mental health services, inadequate number of mental health staff, and mental health not being a priority by policy makers. In addition to these barriers, the psychiatric consultants identified stigma, cost of medications, and worries about medication's side effects as barriers to the utilisation of mental health services. The carers and psychiatrists proposed several solutions to address the barriers to health services utilisation.
  
  
  CONCLUSIONS
  Carers and psychiatrists are aware of the barriers to mental health services utilisation in Sudan. Addressing these barriers require a health policy and political response.
authors.affiliation: Department of Psychiatry, St Patrick's University Hospital, Dublin, Ireland.|Centre for Global Health, University of Dublin, Trinity College, Dublin, Ireland.
authors.forename: Sara H
authors.initials: SH
authors.lastname: Ali
authors.affiliation: Centre for Global Health, University of Dublin, Trinity College, Dublin, Ireland. agyapong@ualberta.ca.|Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada. agyapong@ualberta.ca.|Department of Behavioural Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. agyapong@ualberta.ca.
authors.forename: Vincent I O
authors.initials: VIO
authors.lastname: Agyapong
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology; D003253:Consultants; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D016488:Medicine, African Traditional / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D028642:Persons with Psychiatric Disorders / Q000523:psychology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011570:Psychiatry; D057545:Social Stigma; D013397:Sudan; D055815:Young Adult
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