A struggle throughout: the help-seeking journey to psychological services for common mental disorders in Sleman, Indonesia

Abstract

To respond to the increasing mental health problems in Indonesia and provide accessible services, efforts have been made to integrate psychological services into primary healthcare (PHC), commencing in Sleman Regency, Indonesia. Although these services initially faced challenges, the number of individuals using them has increased significantly in recent years. Previous studies have documented the barriers and facilitators to accessing psychological services in Indonesia. However, the mechanisms and processes of help-seeking (HS) have never been thoroughly understood, particularly in the Indonesian context. The integrated psychological services have also never been evaluated from the perspective of service users. This qualitative study aimed to understand the HS process for common mental disorders within psychological services in PHC in Sleman, Indonesia, from the viewpoint of service users. A total of 15 adult participants were interviewed. The data analysis followed a six-step reflexive thematic analysis employing an inductive approach. The analysis generated four themes, each with three subthemes categorised into barriers and facilitators to HS. We also developed four stages of HS: pre-, early-, during-, and post-, in which the themes occurred. The themes are: (1) developing recognition of the need for psychological help, (2) the yearning to improve amidst stigmatisation, (3) dealing with difficult services, and (4) making sense of the treatment journey. These findings indicated that participants encountered personal, sociocultural, and systemic barriers across these phases, underscoring the complexity of HS in the Indonesian context. Nonetheless, service users demonstrated adaptive coping strategies to overcome challenges and access the services while receiving helpful psychological treatments.