Barriers and Facilitators of Psychological Help-Seeking of People With Depression, Anxiety, and Stress Symptoms Among ASEAN Countries: A Systematic Review

Background: Despite growing rates of common mental health disorders among country members of the Association of Southeast Asia Nations (ASEAN), there continue to be treatment gaps in these countries. Aim: To systematically identify and synthesise barriers and facilitators to accessing formal psychological help for common mental health disorders in the existing literature. Methods: APA PsycINFO, Web of Science, Scopus, and the Indonesian Portal Garuda were searched for studies reporting barriers or facilitators to individuals’ engaging in formal psychological help-seeking for common mental health disorders in country members of ASEAN. Participants in the studies were aged 18 years and above and included both quantitative and qualitative designs. Results were reported using PRISMA guidelines. Due to the heterogeneity of data and study designs, a narrative synthesis was chosen as an analysis strategy. Results: This review included forty-six studies. The barriers to formal psychological help-seeking were (1) social and cultural factors, which comprised of stigma, sociocultural and religious, and treatment-related issues, (2) personal factors, such as low mental health knowledge, self-reliance and disclosure difficulty, and (3) structural factors related to the low availability and affordability of mental health services. The facilitators were (1) social and cultural factors related to social and religious aspects, (2) personal factors comprising personal motivation, the presence and severity of mental health problems, and mental health literacy, and (3) structural factors such as accessibility and the system of mental health services, as well as gender differences. Conclusions: Social, cultural, personal, and structural factors are essential for formal help-seeking in ASEAN. Future studies and intervention development might examine these factors further.