Exploring the Barriers and Facilitators to seeking treatment for Major Depressive Disorder (MDD) among women in South Africa: A qualitative study

Abstract

Thesis (MA)--Stellenbosch University, 2025.Pillay, D. 2025. Exploring the Barriers and Facilitators to seeking treatment for Major Depressive Disorder (MDD) among women in South Africa: A qualitative study. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/c573cb20-8604-417f-8d85-30ecf19d9bacDespite the high prevalence of major depressive disorder (MDD) in South Africa and the availability of effective treatment options, mental health services are underutilized. Individuals living with MDD delay or avoid seeking help for a variety of reasons. In South Africa, there is little research on the barriers and facilitators that women face when seeking treatment for MDD. This study examined the facilitators and barriers that women experience when seeking treatment for MDD in South Africa. The methodology used was exploratory qualitative research, with semi-structured interviews and convenience sampling. The study included 13 women living with MDD from various provinces across the country. The study was conceptualised using Bronfenbrenner's ecological systems theory (EST) as the theoretical foundation. Five main themes and nine subthemes were identified and analysed using thematic analysis. At the microsystem level, attitudinal factors such as a low perceived need for help and the side effects of medication were identified as barriers to treatment. At the mesosystem level, partner support and children were the most significant facilitators of treatment, while external family structures and employment support were highlighted as barriers. At the exosystem level, participants reported access and cost of healthcare services as barriers to treatment, while facilitators included support from healthcare experts and a combined treatment plan of pharmacology and psychotherapy. The stigma associated with MDD emerged as the most significant barrier at the macrosystem level. Furthermore, the participants stated that in order to overcome the treatment barriers of MDD, mental health care services in both public and private facilities should be improved, as should education and awareness of mental health literacy in various social structures. The study's findings revealed that individuals' decisions to seek treatment were influenced and shaped by personal beliefs, support from their partners, children, and healthcare professionals, as well as institutional and structural factors such as health care services and stigmatization of mental health disorders. This study's findings may help address the gap in local literature and contribute to future research on treatment barriers for MDD in South Africa.Master