ArticleBMC public health2025
Facilitators in treatment pathways for depression or anxiety among adults in Nepal: a qualitative study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Unmet Needs in Mental Health: A Cross-Sectional Study on Contact Coverage Gaps and Access to Care for Depression and Anxiety Among Adults in Kailali, Nepal.Brain and behavior · 2026Article
- Article
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8 authors.
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Abstract
backgroundDepression and anxiety are prevalent mental health issues globally, yet many individuals in low- and middle-income countries lack access to treatment. Limited research exists on mental health service utilization in these regions. Understanding the factors that affect access to care and treatment pathways can improve mental health services. This study examines the factors that facilitate the initiation and continuation of treatment for depression or anxiety in Nepal.
methodsThe study was conducted in three districts in Nepal: Jhapa, Chitwan, and Kailali districts, representing the eastern, central, and far-western regions. The participants were adults receiving treatment for depression or anxiety from various healthcare providers. A total of 24 participants were purposively recruited, including 13 with symptoms of depression, 9 with symptoms of anxiety, and 2 with both conditions. We utilized the McGill Illness Narrative Interview, a semi-structured protocol commonly used in mental health research, to collect detailed narratives on symptom experiences, illness accounts, and help-seeking behaviors. Data analysis was performed using a framework and thematic analysis approach with NVIVO software.
resultsTreatment pathways for depression and anxiety in Nepal are complex, involving multiple service providers and recurrent treatment from the same providers. Out of a total of 137 sessions across 24 patients, the majority of sessions were with traditional faith healers (27.7%), followed by private hospitals (19.7%), primary healthcare facilities (16.1%), government hospitals (13.1%), neighboring countries (11.7%), and private clinics (8.0%). Traditional healers were the most popular choice for initial visits, followed by private clinics and government hospitals. Factors such as service quality, provider behavior, availability of trained providers, appointment process, confidentiality, and types of services offered influenced care-seeking decisions. Support from family or friends, awareness of mental health issues, and recommendations from trusted individuals also played a significant role.
conclusionTreatment pathways for depression and anxiety disorders are complex, often involving multiple sessions with various service providers and a combination of services. It is crucial to improve healthcare providers' behavior, appointment scheduling, and consultation quality to encourage individuals to seek care. Raising awareness about mental health conditions and available services through different channels and training traditional healers in mental health could help enhance access to care.
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