Barriers to access to mental health services among Colombia outpatients

Abstract

Background: Access barriers are all situations or conditions that limit seeking, receiving or enjoying benefits offered by the health system. This set of situations translates into underutilization of the services offered. In Colombia, there is little information about barriers to accessing medical care in general, and even less in the specific field of mental health. Aim: To determine the barriers to accessing psychiatric care in outpatients in Santa Marta, Colombia. Methods: The authors designed a cross-sectional study with a non-probability sample of adult patients who consulted between August and December 2018. The barriers to access were measured with a 20-item version of the Barriers to Access to Care Evaluation (BACE) scale. Results: A total of 247 patients participated; they were between 18 and 82 years (mean ( M) = 47.5, standard deviation ( SD) = 13.9). A total of 69 (27.9%) patients classified as having major attitudinal barriers; 62 (25.1%) patients, major barriers related to stigma-discrimination; and 41 (16.6%) patients, major instrumental barriers. Concerning the associated variables, age less than 45 years was related to major attitudinal barriers (odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.6-5.5), major barriers related to stigma-discrimination (OR = 3.8, 95% CI 2.0-7.2) and major instrumental barriers (OR = 2.7, 95% CI 1.3-5.3). Men reported major instrumental barriers more frequently than women (OR = 2.8, 95% CI 1.3-5.8). Conclusion: The major attitudinal, related to stigma-discrimination and instrumental barriers to access frequently delay a consultation with mental health services. Actions are necessary to reduce barriers to accessing mental health care.