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

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.