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Depression and Anxiety Cases in Herat, Afghanistan: Awareness, Accessibility to Mental Health Services and Treatment Gap

Sayed Javid Sadat, Mohammad Rasuli, Ehsan Ahmad Ahmadzadeh, Alireza Hassanzadah, Hamidullah Faqireyan, Mina Alekozay, Abdul Fattah Najm, Aziz-ur-Rahman Niazi

Background: The prevalence of mental disorders is increasing in the world, with anxiety and depression being the most common. In 2017, 3.3% and 4.0% of Afghan population lived with depression and anxiety, respectively. This study aims to identify the treatment gap and level of accessibility of people with depression and/or anxiety to mental health services in Herat province of Afghanistan.

Methods: This institutional-based case-series study was conducted from October 2021 to January 2022. Data on sociodemographic characteristics and the severity of depression and anxiety was collected from Herat Mental Health Registry using a 16-item structured questionnaire. Statistical analyses were performed in IBM SPSS Statistics (version 27).

Results: A total of 133 participants with a mean age of 36.7 ± 9.8 years including 99 (74.4%) male and 34 (25.6%) female made up study participants. One hundred and twenty-one (91.0%) were aware of their mental illness, 51 (38.3%) had access to mental health, 31 (23.3%) received counselling, 26 (19.5%) received medication, and 17 (12.8%) received both medication and counselling. The severity of mental illnesses was inversely related to the level of access and receiving counselling services in this study.

Conclusion: This study revealed the low level of accessibility, huge treatment gap and a considerable discrepancy in the level of awareness and service use among study participants. Results from this study adds to the existing literature on low level of accessibility and treatment gap in low and middle-income countries. This urges international community to dedicate resources for the betterment of services in traumatized regions.