title: Ideological vs. Instrumental Barriers to Accessing Formal Mental Health care in the Developing World: Focus on South-eastern Nigeria.
abstract: The striking gaps in formal mental health care in the developing world are largely traceable to Instrumental and Ideological Barriers. Focusing on south-eastern Nigeria, the study aimed to establish the relative weight, significance and determinants of these barriers for prioritised policy interventions. Multistage sampling method was used to select participants (n = 706) to whom questionnaires were administered. Ideological Barriers (cultural and mental health literacy constraints) were more significantly perceived (84.8%) than Instrumental Barriers (systemic and financial impediments) (56.6%). The study demonstrated the primacy of improved knowledge in plugging the gap in conventional mental health care in a region ironically defined more by systemic and material poverty. This is instructive for prioritised policy interventions with an indication that even if facilities and socio-economic status improve, services will likely be underused without greater improvement in people's conceptualisation of mental illness. It equally underscored the need for cultural competence in mental health service provision.
authors.forename: Ugo
authors.initials: U
authors.lastname: Ikwuka
authors.forename: Niall
authors.initials: N
authors.lastname: Galbraith
authors.forename: Ken
authors.initials: K
authors.lastname: Manktelow
authors.forename: Josephine
authors.initials: J
authors.lastname: Chen-Wilson
authors.forename: Femi
authors.initials: F
authors.lastname: Oyebode
authors.forename: Rosemary C
authors.initials: RC
authors.lastname: Muomah
authors.forename: Anuli
authors.initials: A
authors.lastname: Igboaka
mesh_terms: D003906:Developing Countries; D006801:Humans; D001523:Mental Disorders; D008603:Mental Health; D008605:Mental Health Services; D009549:Nigeria; D011795:Surveys and Questionnaires