Barriers and facilitators to medical help-seeking in rural patients with mental illness: A qualitative meta-synthesis

Abstract

Purpose: Numerous barriers hinder individuals with mental illness from seeking medical assistance in rural regions, yet a comprehensive understanding of these challenges remains elusive. This meta-synthesis aims to understand the barriers and facilitators in medical help-seeking among rural individuals with mental illness.

Methods: We systematically searched seven databases (PubMed, CINAHL, Medline(OVID), PsycINFO(OVID), Cochrane, Embase, and ProQuest) to May 2023 and included the studies if they reported the barriers or/and facilitators to seek health care in rural patients with mental illness. Conduct hand search and citation search on Google Scholar for literature supplements. Thematic analysis was employed.

Results: The study included 27 articles reporting on the barriers and facilitators to seeking medical help in this population from 2007-2023. We ultimately identified themes at 3 levels: the individual with mental illness, the external environment and the health service system.

Conclusions: We must design more effective strategies to improve mental health care access for rural patients, considering cultural nuances and health service utilization patterns. This requires a multi-level approach, tailored to the unique needs of diverse populations.

Keywords: Barriers; Facilitators; Help-seeking; Mental illness; Qualitative Meta-synthesis; Rural.