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      Perceived barriers on mental health services by the family of patients with mental illness

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          Abstract

          Background

          Various efforts have been made by the Indonesian government to improve mental health services. In 2014, the government established Law no 18, which is about mental health and the treatment of people with mental illness covered by the universal health coverage. However, many people still experience difficulty in accessing mental health services. In Indonesia, family plays the role of a caregiver to people with mental illness.

          Objective

          This study aims to identify the perceived barriers on mental health services by families whose members suffers from mental illness.

          Methods

          This study is a qualitative research study with a phenomenological approach. Sampling was conducted by purposive sampling with a sample size of 12 participants. Data were collected using semistructured in-depth interviews. Thematic analysis was performed using Colaizzi steps.

          Results

          The obtained results presented three themes. Theme 1, mental health service affordability; theme 2, mental health service availability; and theme 3, negative attitudes (stigma).

          Conclusion

          Families whose members suffered from mental illness still experienced barriers in relation to mental health services even with universal health coverage. Improved mental health services are related to the health insurance coverage, affordability, availability of mental health services and stigma reduction in the health professionals and wide community.

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          Most cited references12

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          Mental Health Stigma: Society, Individuals, and the Profession.

          Mental health stigma operates in society, is internalized by individuals, and is attributed by health professionals. This ethics-laden issue acts as a barrier to individuals who may seek or engage in treatment services. The dimensions, theory, and epistemology of mental health stigma have several implications for the social work profession.
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            Mental health professionals' attitudes towards people with mental illness: do they differ from attitudes held by people with mental illness?

            Studies investigating mental health professionals' attitudes towards people with mental illness are scarce and there is a lack of comparative studies including both patients' and mental health professionals' attitudes. The aim of the present study was to investigate mental health staff's attitudes towards people with mental illness and compare these with the attitudes of patients in contact with mental health services. A further aim was to relate staff attitudes to demographic and work characteristics. A cross-sectional study was performed including 140 staff and 141 patients. The study included a random sample of outpatients in contact with mental health services in the southern part of Sweden and staff working in these services. Attitudes were investigated using a questionnaire covering beliefs of devaluation and discrimination of people with a mental illness. Negative attitudes were prevalent among staff. Most negative attitudes concerned whether an employer would accept an application for work, willingness to date a person who had been hospitalized, and hiring a patient to take care of children. Staff treating patients with a psychosis or working in inpatient settings had the most negative attitudes. Patient attitudes were overall similar to staff attitudes and there were significant differences in only three out of 12 dimensions. Patients' most negative attitudes were in the same area as the staff's. This study points to the suggestion that mental health care staff may hold negative attitudes and beliefs about people with mental illness with tentative implications for treatment of the patient and development and implementation of evidence-based services. Since patients and staff in most respects share these beliefs, it is essential to develop interventions that have an impact on both patients and staff, enabling a more recovery-oriented staff-patient relationship.
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              Barriers in access to healthcare services for chronic patients in times of austerity: an empirical approach in Greece

              Objectives To investigate the magnitude of barriers in access to health services for chronic patients and the socioeconomic and demographic characteristics that affect them. Methods A cross-sectional study was conducted in 1,594 chronic patients suffering from diabetes, hypertension, COPD and Alzheimer. Logistic regression analyses were carried out in order to explore the factors related to economic and geographical barriers in access, as well as the determinants of barriers due to waiting lists. Results A total of 25% of chronic patients face geographical barriers while 63.5% and 58.5% of them are in front of economic and waiting list barriers, respectively. Unemployed, low-income and low-educated are more likely to face economic barriers in access. Moreover, women, low-income patients, and patients with lower health status are more likely to be in front of geographical barriers. In addition, the probability of waiting lists occurrence is greater for unemployed, employees and low income patients. Conclusions Barriers in access can be mainly attributed to income decrease and unemployment. In this context, health policy measures are essential for removing barriers in access. Otherwise, inequalities may increase and chronic patients’ health status will be deteriorated. These consequences imply adverse effects on health expenditure.
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                Author and article information

                Contributors
                Journal
                Int J Nurs Sci
                Int J Nurs Sci
                International Journal of Nursing Sciences
                Chinese Nursing Association
                2096-6296
                2352-0132
                15 December 2017
                10 January 2018
                15 December 2017
                : 5
                : 1
                : 63-67
                Affiliations
                [1]Nursing Faculty Universitas Airlangga, Surabaya, Indonesia
                Author notes
                []Corresponding author. Kampus C Universitas Airlangga, Jalan Mulyorejo Surabaya, 60115 Surabaya, Jawa Timur, Indonesia. diantristiana@ 123456fkp.unair.ac.id
                Article
                S2352-0132(17)30120-5
                10.1016/j.ijnss.2017.12.003
                6626224
                31406803
                f1b51832-f836-4a5b-ae82-97b160853b59
                © 2017 Chinese Nursing Association. Production and hosting by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 18 April 2017
                : 1 August 2017
                : 11 December 2017
                Categories
                Original Article

                family,mental health services,perceived barrier,qualitative research

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