Qualitative study identifies barriers to depression care in Indonesia

A qualitative study of 21 people receiving outpatient mental health care in Indonesian public and private hospitals identified four interconnected sets of barriers to service utilization: individual factors, family and social influences, treatment-related challenges, and health-system limitations. Stigma cut across all four areas, shaping whether and how participants sought help, continued treatment, and communicated their needs. The findings describe the experiences of people already engaged in outpatient care rather than a population-wide survey of everyone with depression in Indonesia.

Researchers used an exploratory qualitative design and conducted semi-structured interviews with participants who had been diagnosed with depression and were receiving outpatient mental health care. Purposive recruitment sought variation in sociodemographic characteristics and healthcare setting. The researchers analyzed interview data thematically, identifying recurring experiences and organizing them into the four barrier categories. This approach was intended to capture the reasons behind service use and non-use from participants’ perspectives, but it does not establish how frequently the reported barriers occur or whether they apply to people who never enter care.

At the individual level, some participants had difficulty accepting their depression diagnosis. Others described medication fatigue or adherence that depended on how strongly their symptoms affected them. These patterns affected engagement with treatment, although the study did not measure their relative prevalence. Family dynamics also played both facilitating and obstructive roles. Relatives could support access and continuation of care, while family responses could also complicate participants’ ability to seek or maintain services. The interviews therefore portray households not simply as background influences but as active participants in the process of service utilization.

Treatment itself presented additional difficulties. Participants reported medication side effects and delays in experiencing a therapeutic response, both of which could affect willingness or ability to continue treatment. The findings do not quantify side effects, treatment response, or dropout, and they do not determine whether these experiences were caused by particular medications or clinical factors. Instead, they show that the experience of treatment could influence continuity of care for people living with depression.

Health-system barriers included complex referral pathways, limited communication with healthcare providers, and medication shortages. Together with stigma and family influences, these problems disrupted access and continuity of care. The study’s conclusion is that mental health service utilization in Indonesia cannot be reduced to a single explanation: it emerges from interactions among individual responses, social environments, treatment experiences, and the organization of services. The authors call for integrated, patient-centred and culturally responsive approaches that strengthen communication, simplify referral systems, involve families, and support consistent service availability. Because the evidence comes from interviews with 21 care recipients in public and private hospitals, further research is needed to determine the scale and distribution of these barriers across Indonesia’s broader population and healthcare system.

Subject of Research: Barriers to mental health service utilization among people living with depression in Indonesia

Article Title: Barriers to mental health service utilization among people living with depression in Indonesia: a qualitative study

Article References: Febrianti, Y., Puspitasari, I., Widayanti, A. W., & Setiyawati, D. (2026). Barriers to mental health service utilization among people living with depression in Indonesia: a qualitative study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15164-z

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15164-z

Keywords: Depression, Mental health services, Indonesia, Service utilization, Stigma, Medication adherence, Family support, Health-system barriers, Qualitative interviews, Barriers, mental, health