| dc.description.abstract | Vihiga Sub-County, a rural area in Western Kenya has shown a rise in the number of mental health cases. They are currently admitting over 120 patients per month with cases of mental illnesses. In order to scale up mental health care, barriers to health services utilization need to be identified and addressed. The objective of this study was to explore barriers to mental health services utilization in public and private healthcare facilities from the perspectives of the healthcare providers in Vihiga Sub-County, Western Kenya. Mixed methods research was used in this descriptive, hospital-based cross sectional study. Data for objectives one and two were quantitative in nature and collected using the WHO-AIMS tool, while objective three which was qualitative in nature was collected using a Key informant interview guide. Data for objectives one and two were entered into Excel and analyzed using STATA 12. Analysis for objective three was done using N-Vivo 8 software. For objective four, Chi-square tests were conducted to measure the association between the availability of resources and the services offered at the health care facilities in Vihiga Sub-County, western Kenya. Statistical significance was assessed at P≤0.05. There were only, two psychiatric nurses in the entire Sub-County and only two of the eleven health facilities reported having government health expenditure directed towards mental health. Despite the need for hospitalization for individuals with acute or chronic serious mental illness, only one of these health facilities had beds specifically dedicated for people with mental illness and the accommodations were made in the general wards of these facilities. Besides, out of the eleven health facilities, nine had at least one psychotropic medicine of each therapeutic category available in the facility all year long. Three health facilities offered social support services while only one offered psychotherapy and rehabilitation services. None of the health facilities offered interpersonal and social skills training and psycho-educational treatment. In addition to these barriers, the key informants identified inadequate staff, lack of information, funding, infrastructure, and availability of psychotropic medications, as barriers to the utilization of mental health services. There was a significant association between the availability of resources and the services offered at the health care facilities in Vihiga Sub-County, western Kenya. The findings of this study indicate that the mental health services in Vihiga Sub-County are provided under extremely resource-restricted conditions, in terms of infrastructure, manpower, psychotropic medication and finances. Staffing numbers are woefully inadequate and personnel in the sector are overworked. There is also weak integration of mental health services into primary care and none of the primary health care facilities have beds specifically dedicated for people with mental illness.The current study has added knowledge that will be utilized in the improvement of mental health services in Vihiga Sub-County. The findings will help inform stakeholders on the need to study, mobilize and recognize potential resources to deal with mental health problems in Western Kenya. | en_US |
