An integrative review of potential enablers and barriers to accessing mental health services in Ghana

Table 3 Key themes of potential enablers and barriers

Theory	Themes	Subthemes	Number of studies	Papers
Awareness	Barriers to access related to awareness	Knowledge about psychiatric care	2	[29, 31]
		Attitudes towards service users	12	[29, 31,32,33,34,35,36,37,38,39, 42, 64]
		Low priority	3	[10, 29, 30]
	Enablers to access related to awareness	Support services	9	[29, 33, 39, 40, 42,43,44, 46]
		Mental health law	3	[30, 40, 41]
Affordability	Barriers to access related to affordability	Treatment and medication cost	6	[31, 33, 35, 49, 50, 52]
Affordability	Barriers to access related to affordability	Limited funding	6	[29, 30, 35, 40, 46, 50]
Accessibility	Barriers to access related accessibility	Transportation and geographical proximity	2	[40, 54]
	Enablers to access related to accessibility	Decentralisation and integration	4	[40,41,42, 55]
		Referral system	4	[35, 40, 51, 56]
		Irregular medicine supply and prescription	6	[30, 35, 40, 46, 49, 50]
		Poor state of psychiatric facilities	4	[30, 31, 35, 36]
		Poor management of mental health cadres	8	[30, 31, 35, 36, 40, 46,47,48]
	Enablers to access related to accessibility	Task-shifting		[35, 40, 42, 47, 51]
Acceptability	Barriers to access related acceptability	Perceived efficacy of medication	7	[30, 36, 47, 49, 54, 56, 57]
		Relapsed treatment	3	[49, 55, 57]
		Discontinuity of medications	1	[57]
Adequacy	Barriers to access related to adequacy	Limited mental health services for marginalised groups	3	[35, 40, 46]

ISSN: 1478-4505