Barriers to Accessing Mental Health Services among Schizophrenia Patients: A Qualitative Study on Patient Experiences and Systemic Challenges

Authors

  • Franklin E. Ibadin Health Sciences, Public Health in Epidemiology, Purdue University Global, West Lafayette, Indiana, USA
  • Excel Onajite Ernest-Okonofua Department of Public Health, South Wales University, Newport, Wales, UK
  • Trevor Efosa Edobor General Practice Vocational Training Scheme, National Health Service, England, UK
  • Aminu Sufu Mahmud Department of Mental Health, University of South Alabama, Mobile, Alabama, USA

DOI:

https://doi.org/10.54536/ajhp.v4i1.4117

Keywords:

Mental health, Schizophrenia, Stigma

Abstract

Schizophrenia is a serious mental illness that causes considerable social and personal dysfunction. The study aims to identify and analyze the barriers that schizophrenia patients face in accessing mental health services. A qualitative cross-sectional study design and semi-structured interviews were conducted with the consent of twenty schizophrenia patients who recently sought the services of a mental health facility. Recruitment was carried out through clinics, and support groups for hemochromatosis individuals. Transcripts of the interviews were analyzed using thematic analysis to establish common themes and care-related barriers. The analysis revealed five main barriers: organizational restraint, providers and systems, social and psychological, resource limitation, and improvement recommendations. The study supports patient-information-level and policy-level interventions on care integration, stigma, and mental health services. These barriers potentially construct mental health service usage and quality for consumers with schizophrenia, enhancing both health status and quality of life

References

Alegría, M., Chatterji, P., Wells, K., Cao, Z., Chen, C.-n., & Takeuchi, D. (2008). Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatric Services, 59(11), 1264–1272. https://doi.org/10.1176/ps.2008.59.11.1264

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Braun, V., & Clarke, V. (2012). Thematic analysis. American Psychological Association.

Breslau, J., Marshall, G. N., Pincus, H. A., & Brown, R. A. (2014). Are mental disorders more common in urban than rural areas of the United States? Journal of Psychiatric Research, 56, 50–55. https://doi.org/10.1016/j.jpsychires.2014.05.004

Corrigan, P. W., & Watson, A. C. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry, 1(1), 16–20.

Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest, 15(2), 37–70. https://doi.org/10.1177/1529100614531398

Creswell, J. W., & Poth, C. N. (2016). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). SAGE Publications.

Galletly, C., Castle, D., Dark, F., Humberstone, V., Jablensky, A., & Killackey, E. (2016). Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Australian & New Zealand Journal of Psychiatry, 50(5), 410–472. https://doi.org/10.1177/0004867416641195

Green, M. F. (1996). What are the functional consequences of neurocognitive deficits in schizophrenia? The American Journal of Psychiatry, 153(3), 321–330. https://doi.org/10.1176/ajp.153.3.321

Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82. https://doi.org/10.1177/1525822X05279903

Harvey, P. D., Heaton, R. K., Carpenter, W. T., Jr., Green, M. F., Gold, J. M., & Schoenbaum, M. (2012). Functional impairment in people with schizophrenia: Focus on employability and eligibility for disability compensation. Schizophrenia Research, 140(1–3), 1–8. https://doi.org/10.1016/j.schres.2012.03.025

Jääskeläinen, E., Juola, P., Hirvonen, N., McGrath, J. J., Saha, S., & Isohanni, M. (2013). A systematic review and meta-analysis of recovery in schizophrenia. Schizophrenia Bulletin, 39(6), 1296–1306. https://doi.org/10.1093/schbul/sbs130

Jackson, K., & Bazeley, P. (2019). Qualitative data analysis with NVivo (3rd ed.). SAGE Publications.

Kane, J. M., Robinson, D. G., Schooler, N. R., Mueser, K. T., Penn, D. L., & Rosenheck, R. A. (2016). Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. American Journal of Psychiatry, 173(4), 362–372. https://doi.org/10.1176/appi.ajp.2015.15050632

Kvale, S. (2009). Interviews: Learning the craft of qualitative research interviewing (2nd ed.). SAGE Publications.

Leucht, S., Cipriani, A., Spineli, L., Mavridis, D., Örey, D., & Richter, F. (2013). Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: A multiple-treatments meta-analysis. The Lancet, 382(9896), 951–962. https://doi.org/10.1016/S0140-6736(13)60733-3

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. SAGE Publications.

Link, B. G., Struening, E. L., Rahav, M., Phelan, J. C., & Nuttbrock, L. (1997). On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior, 38(2), 177–190. https://doi.org/10.2307/2955424

Marshall, C., & Rossman, G. B. (2014). Designing qualitative research (5th ed.). SAGE Publications.

McGorry, P. D., Killackey, E., & Yung, A. (2008). Early intervention in psychosis: Concepts, evidence and future directions. World Psychiatry, 7(3), 148–156.

Mead, N., & Bower, P. (2000). Patient-centredness: A conceptual framework and review of the empirical literature. Social Science & Medicine, 51(7), 1087–1110. https://doi.org/10.1016/S0277-9536(00)00098-8

Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods, 16(1), 1–13. https://doi.org/10.1177/1609406917733847

Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 42(5), 533–544. https://doi.org/10.1007/s10488-013-0528-y

Patton, M. Q. (2014). Qualitative research & evaluation methods: Integrating theory and practice (4th ed.). SAGE Publications.

Pescosolido, B. A., Medina, T. R., Martin, J. K., & Long, J. S. (2013). The “backbone” of stigma: Identifying the global core of public prejudice associated with mental illness. American Journal of Public Health, 103(5), 853–860. https://doi.org/10.2105/AJPH.2012.301147

Pitschel-Walz, G., Leucht, S., Bäuml, J., Kissling, W., & Engel, R. R. (2001). The effect of family interventions on relapse and rehospitalization in schizophrenia—A meta-analysis. Schizophrenia Bulletin, 27(1), 73–92.

Prins, M. A., Verhaak, P. F. M., Bensing, J. M., & van der Meer, K. (2008). Health beliefs and perceived need for mental health care of anxiety and depression—The patients’ perspective explored. Clinical Psychology Review, 28(6), 1038–1058. https://doi.org/10.1016/j.cpr.2008.02.009

Reavley, N. J., & Jorm, A. F. (2011). Young people’s stigmatizing attitudes towards people with mental disorders: Findings from an Australian national survey. Australian & New Zealand Journal of Psychiatry, 45(12), 1033–1039. https://doi.org/10.3109/00048674.2011.621060

Rosenfield, S. (1997). Labeling mental illness: The effects of received services and perceived stigma on life satisfaction. American Sociological Review, 62(4), 660–672. https://doi.org/10.2307/2657432

Rössler, W., Salize, H. J., Van Os, J., & Riecher-Rössler, A. (2005). Size of burden of schizophrenia and psychotic disorders. European Neuropsychopharmacology, 15(4), 399–409. https://doi.org/10.1016/j.euroneuro.2005.04.009

Saldaña, J. (2021). The coding manual for qualitative researchers (4th ed.). SAGE Publications.

Saxena, S., Thornicroft, G., Knapp, M., & Whiteford, H. (2007). Resources for mental health: Scarcity, inequity, and inefficiency. The Lancet, 370(9590), 878–889. https://doi.org/10.1016/S0140-6736(07)61239-2

Smith, T. E., Easter, A., Pollock, M., Pope, L. G., & Wisdom, J. P. (2013). Disengagement from care: Perspectives of individuals with serious mental illness and of service providers. Psychiatric Services, 64(8), 770–775. https://doi.org/10.1176/appi.ps.201200463

Stuart, H. (2006). Mental illness and employment discrimination. Current Opinion in Psychiatry, 19(5), 522–526. https://doi.org/10.1097/01.yco.0000238482.27264.0d

Substance Abuse and Mental Health Services Administration. (2014). National survey on drug use and health. U.S. Department of Health and Human Services.

Thornicroft, G., Brohan, E., Rose, D., Sartorius, N., & Leese, M. (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: A cross-sectional survey. The Lancet, 373(9661), 408–415. https://doi.org/10.1016/S0140-6736(08)61817-6

Thornicroft, G., Deb, T., & Henderson, C. (2016). Community mental health care worldwide: Current status and further developments. World Psychiatry, 15(3), 276–286. https://doi.org/10.1002/wps.20349

Van Os, J., Kenis, G., & Rutten, B. P. (2010). The environment and schizophrenia. Nature, 468(7321), 203–212. https://doi.org/10.1038/nature09563

World Health Organization. (2022). Schizophrenia. https://www.who.int/news-room/fact-sheets/detail/schizophrenia

Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2008). Cognitive behavior therapy for schizophrenia: Effect sizes, clinical models, and methodological rigor. Schizophrenia Bulletin, 34(3), 523–537. https://doi.org/10.1093/schbul/sbm114

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Published

2026-01-07

How to Cite

Ibadin, F. E. ., Ernest-Okonofua, E. O. ., Edobor, T. E. ., & Mahmud, A. S. . (2026). Barriers to Accessing Mental Health Services among Schizophrenia Patients: A Qualitative Study on Patient Experiences and Systemic Challenges. American Journal of Human Psychology, 4(1), 1-7. https://doi.org/10.54536/ajhp.v4i1.4117

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