BARRIERS AND ACCESS TO MENTAL HEALTHCARE IN RURAL AREAS OF PAKISTAN: AN INFERENTIAL STATISTICAL ANALYSIS
Main Article Content
Keywords
Mental Healthcare, Socio cultural Barriers, Economic Barriers, Accessibility and Availability
Abstract
Background: Mental healthcare accessibility remains a significant challenge in rural Pakistan, where services are limited, and socio-cultural barriers, including stigma, further hinder utilization. This study investigates these barriers and explores factors influencing access to mental healthcare services in rural areas.
Objectives: The study aims to: 1) assess the availability and accessibility of mental healthcare services; 2) examine mental health awareness levels; 3) identify socio-cultural and economic barriers; and 4) estimate the association between demographic factors and access to mental healthcare.
Methodology: A cross-sectional survey design was employed, collecting data from 500 respondents in rural Pakistan using a structured questionnaire. Stratified random sampling was used to ensure representativeness. Analytical techniques such as chi-square tests, logistic regression, ANOVA, and Pearson correlation were applied to examine associations between variables, including income, education, and stigma.
Results: Only 28% of respondents reported local availability of mental healthcare services, with 78% lacking access to mental health professionals. Travel distances, long waiting times, and high costs were identified as significant barriers. Stigma was pervasive, with 38% of respondents reporting strong stigma, and 64% avoiding treatment. Logistic regression showed that higher income and education significantly increased the likelihood of accessing mental healthcare, while stigma reduced utilization.
Conclusion: The study underscores the urgent need for mental healthcare infrastructure expansion, targeted awareness campaigns, and telehealth services in rural Pakistan. Addressing socio-cultural stigma and affordability issues is essential for improving mental health outcomes in these communities.
Objectives: The study aims to: 1) assess the availability and accessibility of mental healthcare services; 2) examine mental health awareness levels; 3) identify socio-cultural and economic barriers; and 4) estimate the association between demographic factors and access to mental healthcare.
Methodology: A cross-sectional survey design was employed, collecting data from 500 respondents in rural Pakistan using a structured questionnaire. Stratified random sampling was used to ensure representativeness. Analytical techniques such as chi-square tests, logistic regression, ANOVA, and Pearson correlation were applied to examine associations between variables, including income, education, and stigma.
Results: Only 28% of respondents reported local availability of mental healthcare services, with 78% lacking access to mental health professionals. Travel distances, long waiting times, and high costs were identified as significant barriers. Stigma was pervasive, with 38% of respondents reporting strong stigma, and 64% avoiding treatment. Logistic regression showed that higher income and education significantly increased the likelihood of accessing mental healthcare, while stigma reduced utilization.
Conclusion: The study underscores the urgent need for mental healthcare infrastructure expansion, targeted awareness campaigns, and telehealth services in rural Pakistan. Addressing socio-cultural stigma and affordability issues is essential for improving mental health outcomes in these communities.
References
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26. Naz, S, M. Ayub., M. J. Afridi. (2023d). Factors affecting the choice of delivery among the rural women of Khyber Pakhtunkhwa Pakistan. Journal of Development and Social Sciences, 4(3), 23-30.
27. Naz, S. & N. P. Khan. (2018a). Financial contribution of livestock at household level in Federally Administered Tribal Areas of Pakistan: An empirical perspective. Sarhad. Journal of Agriculture, 34(1), 1-9.
28. Naz, S., A. Ahmed, S. Nawab, R. Karim, Azra, M. Azam, and M. J. Afridi. (2021). Gendered division of household labour in livestock with potential to achieve gender equality; a case of district Mohmand, erstwhile FATA, Khyber Pakhtunkhwa-Pakistan. Webology., 18(4), 1754-1768
29. Naz, S., Amin, H., Sayed, A. (2024a). Maternal mortality in Pakistan; the potential role of community midwives. Journal of Development and Social Sciences, 5(2), 45-52.
30. Naz, S., Aslam, M., Karim, R. (2022a). Social and cultural factors influencing maternal mortality in Khyber Pakhtunkhwa, Pakistan. Journal of Positive School Psychology, 6(10), 453-465.
31. Naz, S., Aslam, M., Karim, R. (2022b). Healthcare Behavior, utilization and associated factors in the rural areas of Khyber Pakhtunkhwa, Pakistan. Journal of Development and Social Sciences, 3(4), 254-265.
32. Naz, S., Aslam, M., Sayed, A. (2023b). Prevalence of anemia and its determinants among the rural women of Khyber Pakhtunkhwa, Pakistan. Annals of Human and Social Sciences, 4(4), 42-50.
33. Naz, S., Khan, M. A., Azam, O. (2023a). Determinants of rural women’s healthcare behavior in the rural areas of Khyber Pakhtunkhwa, Pakistan. Journal of Development and Social Sciences, 4(1), 160-168.
34. Naz, S., Khan, N.P., Khan, H. & Azra. (2020). Does women’s participation in livestock management enhance their empowerment? An insight from the tribal belt of Pakistan. Sarhad Journal of Agriculture, 36(3): 823-831.
35. Naz, S., M. Aslam, H. Amin., S. Khan, A. Sayed. (2024b). Mental healthcare access in Pakistan: a contemporary study. Journal of Population Therapeutics & Clinical Pharmacology, 31(8), 2005-2012.
36. Naz, S., N.P. Khan, N. Afsar & A.A. Shah. (2018b). Women’s participation and constraints in livestock management: A case of Khyber Pakhtunkhwa Province Pakistan. Sarhad Journal of Agriculture, 34(4), 917-923.
37. Naz, S., O, Khan, R. Karim. (2023c). Gender disparities in livestock management and control over livestock income in erstwhile FATA, Khyber Pakhtunkhwa, Pakistan. Annals of Human and Social Sciences, 4(1), 137-149.
38. Onyango, J., Dixon, S., & Patel, V. (2021). The mental health treatment gap in Sub-Saharan Africa: Current challenges and future directions. BMC Psychiatry, 21(1), 225-238. https://doi.org/10.1186/s12888-021-03450-z
39. Patel, V., Kleinman, A., & Saraceno, B. (2021). Mental health in the global development agenda. The Lancet Psychiatry, 8(9), 756-757. https://doi.org/10.1016/S2215-0366(21)00156-4
40. Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Rahman, M. H. (2008). Poverty and access to healthcare in developing countries. Annals of the New York Academy of Sciences, 1136(1), 161-171.
41. Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia, 126(5), 1763-1768.
42. WHO. (2022). Mental health and COVID-19: Early evidence of the pandemic’s impact. World Health Organization. https://www.who.int/publications/i/item/9789240033987
43. Zafar, S., Bashir, A., & Iqbal, F. (2023). Mental healthcare challenges in Pakistan’s rural regions: An empirical analysis. Pakistan Journal of Public Health, 18(2), 75-90. https://doi.org/10.4103/pjph2023.009
44. Zaidi, A., A. Karim, S. Mohiuddin, A. Khan, A. Syed., M. Jehangir, I. Afzal. (2018). Dental sensitivity associated with consumption of fizzy drinks: a cross sectional study. Pakistan Journal of Medicine and Dentistry, 7(04), 71-75.
2. Ahmed, T., Malik, R., & Hussain, N. (2023). Rural mental health in developing countries: Challenges and opportunities. Journal of Global Health, 15(2), 125-137. https://doi.org/10.1016/j.jgh.2023.00125
3. Ali, S., Bashir, A., & Khan, M. A. (2022). Mental healthcare access in urban versus rural Pakistan: An exploratory study. Pakistan Journal of Social Sciences, 19(1), 56-70. https://doi.org/10.1080/pjss.2022.10965
4. Babbie, E. (2020). The Practice of Social Research. Cengage Learning.
5. Bashir, A., Zafar, S., & Ahmed, T. (2022). Availability of mental health professionals in rural Pakistan: A critical analysis. International Journal of Mental Health Systems, 16(3), 345-358. https://doi.org/10.1186/s13033-022-00698-2
6. Cochran, W. G. (1977). Sampling Techniques. John Wiley & Sons.
7. Denscombe, M. (2014). The Good Research Guide: For Small-Scale Social Research Projects. McGraw-Hill Education.
8. Dixon, S., Patel, V., & Haroz, E. E. (2022). Mental health in developing countries: A call for innovation. The Lancet Psychiatry, 9(6), 445-446. https://doi.org/10.1016/S2215-0366(22)00148-2
9. Etikan, I., & Bala, K. (2017). Sampling and sampling methods. Biometrics & Biostatistics International Journal, 5(6), 00149.
10. Field, A. (2013). Discovering Statistics Using IBM SPSS Statistics. Sage.
11. Fisher, R. A. (1954). Statistical Methods for Research Workers. Oliver and Boyd.
12. Fowler, F. J. (2013). Survey Research Methods. Sage.
13. Gagné, M., Tremblay, R., & Hall, N. (2023). Overcoming mental health disparities in rural communities: Challenges and strategies. Canadian Journal of Rural Health, 28(2), 111-126. https://doi.org/10.1177/17111512
14. Haroz, E. E., Patel, V., & Kleinman, A. (2021). Mental health interventions for the developing world: A global imperative. Psychiatric Clinics of North America, 44(3), 561-577. https://doi.org/10.1016/j.psc.2021.05.003
15. Hosmer, D. W., Lemeshow, S., & Sturdivant, R. X. (2013). Applied Logistic Regression. Wiley.
16. Hussain, N., Khan, S., & Malik, R. (2023). Exploring the mental healthcare challenges in Pakistan’s rural regions: Implications for policy. South Asian Journal of Mental Health, 20(4), 120-135. https://doi.org/10.1177/sajmh203456
17. Iqbal, F., Zafar, S., & Jameel, A. (2021). Socio-cultural barriers to mental healthcare access in rural Pakistan: A case study. Asian Journal of Social Science, 17(2), 99-112. https://doi.org/10.1111/ajss.302
18. Jorm, A. F., et al. (1997). Mental health literacy: A survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. The Medical Journal of Australia, 166(4), 182-186.
19. Khan, A., Malik, S., & Bashir, A. (2022). Mental health stigma in rural Pakistan: A qualitative exploration of beliefs and attitudes. International Journal of Public Health, 67(1), 101-110. https://doi.org/10.3389/ijph.2022.10110
20. Levin, K. A. (2006). Study design III: Cross-sectional studies. Evidence-Based Dentistry, 7(1), 24-25.
21. Likert, R. (1932). A technique for the measurement of attitudes. Archives of Psychology, 140, 1-55.
22. Malik, S., Khan, A., & Hussain, N. (2023). Addressing cultural stigma in mental health: Lessons from rural Pakistan. Journal of Mental Health Research in Developing Countries, 9(1), 34-46. https://doi.org/10.1080/jmhrdc.2023.02.089
23. McHugh-, M. L. (2013). The chi-square test of independence. Biochemia Medica, 23(2), 143-149.
24. Mendenhall, E. (2021). Poverty, mental health, and social exclusion: Integrating health and economic development in low-income settings. Global Public Health, 16(8), 1098-1113. https://doi.org/10.1080/17441692.2021.1904324
25. Monaghan, A., & Campbell, J. (2022). Mental health service provision in rural Canada: Barriers and facilitators. Canadian Journal of Community Mental Health, 41(2), 85-102. https://doi.org/10.7870/cjcmh-2022-012
26. Naz, S, M. Ayub., M. J. Afridi. (2023d). Factors affecting the choice of delivery among the rural women of Khyber Pakhtunkhwa Pakistan. Journal of Development and Social Sciences, 4(3), 23-30.
27. Naz, S. & N. P. Khan. (2018a). Financial contribution of livestock at household level in Federally Administered Tribal Areas of Pakistan: An empirical perspective. Sarhad. Journal of Agriculture, 34(1), 1-9.
28. Naz, S., A. Ahmed, S. Nawab, R. Karim, Azra, M. Azam, and M. J. Afridi. (2021). Gendered division of household labour in livestock with potential to achieve gender equality; a case of district Mohmand, erstwhile FATA, Khyber Pakhtunkhwa-Pakistan. Webology., 18(4), 1754-1768
29. Naz, S., Amin, H., Sayed, A. (2024a). Maternal mortality in Pakistan; the potential role of community midwives. Journal of Development and Social Sciences, 5(2), 45-52.
30. Naz, S., Aslam, M., Karim, R. (2022a). Social and cultural factors influencing maternal mortality in Khyber Pakhtunkhwa, Pakistan. Journal of Positive School Psychology, 6(10), 453-465.
31. Naz, S., Aslam, M., Karim, R. (2022b). Healthcare Behavior, utilization and associated factors in the rural areas of Khyber Pakhtunkhwa, Pakistan. Journal of Development and Social Sciences, 3(4), 254-265.
32. Naz, S., Aslam, M., Sayed, A. (2023b). Prevalence of anemia and its determinants among the rural women of Khyber Pakhtunkhwa, Pakistan. Annals of Human and Social Sciences, 4(4), 42-50.
33. Naz, S., Khan, M. A., Azam, O. (2023a). Determinants of rural women’s healthcare behavior in the rural areas of Khyber Pakhtunkhwa, Pakistan. Journal of Development and Social Sciences, 4(1), 160-168.
34. Naz, S., Khan, N.P., Khan, H. & Azra. (2020). Does women’s participation in livestock management enhance their empowerment? An insight from the tribal belt of Pakistan. Sarhad Journal of Agriculture, 36(3): 823-831.
35. Naz, S., M. Aslam, H. Amin., S. Khan, A. Sayed. (2024b). Mental healthcare access in Pakistan: a contemporary study. Journal of Population Therapeutics & Clinical Pharmacology, 31(8), 2005-2012.
36. Naz, S., N.P. Khan, N. Afsar & A.A. Shah. (2018b). Women’s participation and constraints in livestock management: A case of Khyber Pakhtunkhwa Province Pakistan. Sarhad Journal of Agriculture, 34(4), 917-923.
37. Naz, S., O, Khan, R. Karim. (2023c). Gender disparities in livestock management and control over livestock income in erstwhile FATA, Khyber Pakhtunkhwa, Pakistan. Annals of Human and Social Sciences, 4(1), 137-149.
38. Onyango, J., Dixon, S., & Patel, V. (2021). The mental health treatment gap in Sub-Saharan Africa: Current challenges and future directions. BMC Psychiatry, 21(1), 225-238. https://doi.org/10.1186/s12888-021-03450-z
39. Patel, V., Kleinman, A., & Saraceno, B. (2021). Mental health in the global development agenda. The Lancet Psychiatry, 8(9), 756-757. https://doi.org/10.1016/S2215-0366(21)00156-4
40. Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Rahman, M. H. (2008). Poverty and access to healthcare in developing countries. Annals of the New York Academy of Sciences, 1136(1), 161-171.
41. Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia, 126(5), 1763-1768.
42. WHO. (2022). Mental health and COVID-19: Early evidence of the pandemic’s impact. World Health Organization. https://www.who.int/publications/i/item/9789240033987
43. Zafar, S., Bashir, A., & Iqbal, F. (2023). Mental healthcare challenges in Pakistan’s rural regions: An empirical analysis. Pakistan Journal of Public Health, 18(2), 75-90. https://doi.org/10.4103/pjph2023.009
44. Zaidi, A., A. Karim, S. Mohiuddin, A. Khan, A. Syed., M. Jehangir, I. Afzal. (2018). Dental sensitivity associated with consumption of fizzy drinks: a cross sectional study. Pakistan Journal of Medicine and Dentistry, 7(04), 71-75.
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Sep 25, 2024
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Kinza Riaz, Muhammad Sajid, Muhammad Ishtiaq, & Humera Amin. (2024). BARRIERS AND ACCESS TO MENTAL HEALTHCARE IN RURAL AREAS OF PAKISTAN: AN INFERENTIAL STATISTICAL ANALYSIS. Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 2892-2902. https://doi.org/10.53555/mhznzr83
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Author Biographies
Kinza Riaz
Student of Masters in Information Technology, University of Potomac, Virginia Campus, United States of America.
Muhammad Sajid
Institute of Development Studies, The University of Agriculture, Peshawar, KP, Pakistan
Muhammad Ishtiaq
Master in Public Health, Sarhad Institute of Health Sciences, Sarhad University of Science and Information Technology, KP, Pakistan.
Humera Amin
Assistan Professor, Department of Agricultural Extension and Rural Studies, Sargodha University, Sargodha, Pakistan.
How to Cite
Kinza Riaz, Muhammad Sajid, Muhammad Ishtiaq, & Humera Amin. (2024). BARRIERS AND ACCESS TO MENTAL HEALTHCARE IN RURAL AREAS OF PAKISTAN: AN INFERENTIAL STATISTICAL ANALYSIS. Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 2892-2902. https://doi.org/10.53555/mhznzr83