Abstract
Mental health problems are a significant and growing cause of morbidity worldwide. Despite the availability of evidence-based interventions, most people experiencing mental health problems remain untreated. This treatment gap is particularly large in low- and middle-income countries (LMIC) and is due to both supply-side and demand-side barriers. The aim of this systematic review is to identify and synthesise the evidence on interventions to improve help-seeking for mental health problems in LMICs. The protocol was registered a priori (Registration number: CRD42021255635). We searched eight databases using terms based on three concepts: ‘mental health/illness’ AND ‘help-seeking’ AND ‘LMICs’; and included all age groups and mental health problems. Forty-two papers were eligible and included in this review. Intervention components were grouped into three categories following the steps in the help-seeking process: (1) raising mental health awareness among the general population (e.g., distribution of printed or audio-visual materials), (2) identification of individuals experiencing mental health problems (e.g., community-level screening or detection), and (3) promoting help-seeking among people in need of mental health care (e.g., sending reminders). The majority of interventions (80%) included components in a combination of the aforementioned categories. Most studies report positive outcomes, yet results on the effectiveness is mixed, with a clear trend in favour of interventions with components from more than one category. Ten out of 42 studies (24%) yielded a statistically significant effect of the intervention on help-seeking; and all targeted a combination of the aforementioned categories (i.e., raising awareness, identification and help-seeking promotion). Only six studies (14%) focused on children and adolescents. Due to the limited number of robust studies done in LMICs and the heterogeneity of study designs, outcomes and components used, no definite conclusions can be drawn with regards to the effects of individual strategies or content of the interventions.
| Original language | English |
|---|---|
| Article number | e0002302 |
| Number of pages | 29 |
| Journal | PLoS Global Public Health |
| Volume | 3 |
| Issue number | 9 |
| Early online date | 13 Sept 2023 |
| DOIs | |
| Publication status | Published - 13 Sept 2023 |
Bibliographical note
Funding: This review was conducted as a part of a research study called IMPlementation of evidencebased facility and community interventions to reduce the treatment gap for depRESSion (IMPRESS) funded by a grant from National Institute of Mental Health [Grant number: RO1MH115504]. This grant supports Yashi Gandhi, Urvita Bhatia, Vikram Patel, Daisy Singla, Richard Velleman, Helen Weiss, Ankur Garg, Miriam Sequeira, Veera Pudsekar and AbhijitNadkarni. Myrthe van den Broek and Mark Jordans were supported by Sint Antonius Stichting Projects (SAS-P) [Grant number: SAS-P-21103-UG].
Neither of the funders had any role in the study design and implementation of the research.
