Barriers to treatment among members of a mental health advocacy group in South Africa

Background. As part of an international survey of mental health advocacy groups, information pertinent to patients' concerns regarding their diagnosis and treatment was gathered from South African members of a depression and anxiety support group (n=404). Methods. Questionnaires developed by GAMIAN, an international consortium of advocacy groups, were mailed along with explanatory letters and self-addressed envelopes to South African members and members in nine other countries, for completion. Of 1,000 questionnaires mailed in South Africa, 40.4% were returned. Results. The sample comprised patient members with anxiety-only (39%), depression-only (8%), mixed anxiety-depression (26%), and other diagnoses (27%). While one-third of respondents reported onset of symptoms before the age of 20, most waited 3-5 years before seeking help. After making contact with the health system, respondents experienced further delays in obtaining a correct diagnosis. In many instances, respondents were poorly informed of diagnosis and treatment (25%), and nearly half of all respondents discontinued treatment on account of side-effects. Conclusions. Attempts to improve awareness of mental illness, and better communication between physicians and their patients, might help to break down some of the barriers patients encounter when seeking help.