Original Research

Barriers to care among people with schizophrenia attending a tertiary psychiatric hospital in Nigeria

Bawo O. James, Felicia I. Thomas, Omonefe J. Seb-Akahomen, Nosa G. Igbinomwanhia, Chinwe F. Inogbo, Graham Thornicroft
South African Journal of Psychiatry | Vol 25 | a1392 | DOI: https://doi.org/10.4102/sajpsychiatry.v25i0.1392 | © 2019 Bawo O. James, Felicia I. Thomas, Omonefe J. Seb-Akahomen, Nosa G. Igbinomwanhia, Chinwe F. Inogbo, Graham Thornicroft | This work is licensed under CC Attribution 4.0
Submitted: 15 March 2019 | Published: 21 October 2019

About the author(s)

Bawo O. James, Department of Clinical Services, Federal Neuro-Psychiatric Hospital, Benin City, Nigeria
Felicia I. Thomas, Synapse Centre for Psychological Medicine, Lagos, Nigeria
Omonefe J. Seb-Akahomen, Department of Clinical Services, Federal Neuro-Psychiatric Hospital, Benin City, Nigeria
Nosa G. Igbinomwanhia, Department of Clinical Services, Federal Neuro-Psychiatric Hospital, Benin City, Nigeria
Chinwe F. Inogbo, Department of Clinical Services, Federal Neuro-Psychiatric Hospital, Benin City, Nigeria
Graham Thornicroft, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neurosciences, Kings College London, England, United Kingdom


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Abstract

Background: Individuals with schizophrenia in low- and middle-income countries and their caregivers face multiple barriers to care-seeking and continuous engagement with treatment services. Identifying specific barrier patterns would aid targeted interventions aimed at improving treatment access.

Aim: The aim of this study was to determine stigma- and non-stigma-related barriers to care-seeking among persons with schizophrenia in Nigeria.

Setting: This study was conducted at the Outpatient Clinics of the Federal Neuro-Psychiatric Hospital, Benin City, Nigeria.

Methods: A cross-sectional study of a dyad of persons with schizophrenia and caregivers (n = 161) attending outpatient services at a neuro-psychiatric hospital in Nigeria. Stigma- and non-stigma-related barriers were assessed using the 30-item Barriers to Access to Care Evaluation (BACE) scale.

Results: Lack of insight, preference for alternative care, illness severity and financial constraints were common barriers to care-seeking among persons with schizophrenia. Females were significantly more likely to report greater overall treatment barrier (p < 0.01) and stigma-related barriers (p < 0.02).

Conclusion: This study shows that attitudinal barriers impede care access and engagement among persons with schizophrenia in Nigeria.


Keywords

barriers to care; schizophrenia; stigma; Nigeria; attitudes

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