Access to mental health care service remains a major problem globally, but more obvious in
developing countries including the Gambia. In general, mental illnesses even though are
acknowledged as great contributors to the global burden of disease, they receive little
attention at global, regional and local levels compared to other illnesses such as
communicable diseases.
Access to mental health care in the Gambia deserves urgent attention. Whereas no recent
study is done to examine the prevalent rate and treatment gap, the available data shows
that 90% of mentally ill patients who require treatment do not receive it.
The aim of this study was to contribute to the improvement of access to mental health care
service by exploring factors that influence access to mental health care service in the Gambia
using a qualitative research design. In-depth interviews with 15 mentally ill patients using
the community mental health services and 5 focus group discussions with the general
population in the same health region were conducted.
The findings of this study highlight many factors that could influence access to mental health
care service among people with mental illness in the Gambia. The most important of these
factors that shed light on access to mental health care service include; perception of and
believed causes of mental illness; In addition mental health service (biomedical) is scarce for
most of the population resulting in patients and their families using what is available and
also travel long distance to access services. The lack of satisfaction from these services also
leads to syncretic use of different treatment systems, coupled with high cost of treatment
(traditional system) and antipsychotic medicine. The findings further show that the patient’s
family shoulder the responsibility of providing the required financial resources for treatment
and medication, but also decide where treatment is sort from.
Efforts to improve access to mental health services should be approached holistically, as it is
influenced by social, family and health system factors. This study however provides a base
for action to address access to mental health care service. Collaboration with traditional
healers, provision of mental health services through the community mental health team and
long term plan to address poverty can improve access to mental health service in Gambia.