Development and Validation of the Barriers to Mental Health Service Utilization Scale (BMHSUS) in Bangladesh: An In-Depth Analysis of Sociodemographic Influences on Access Barriers – Insights from the National Mental Health Survey

Background: Mental Health Service Utilization (MHSU) in Bangladesh remains low due to cultural, societal, and structural barriers, including stigma, fear of ostracization, reliance on traditional healers, medication concerns, limited access, and sociodemographic factors such as age, gender, and location. This study aims to develop and validate a tool for assessing barriers to MHSU in Bangladesh and explore the influence of sociodemographic factors on these barriers.Methods: The National Mental Health Survey, conducted from July 2019 to May 2020, was a multicentric, community-based study using stratified cluster random sampling from 496 primary sampling units (PSUs) across Bangladesh. After addressing missing data, 7,238 completed datasets were analyzed. The survey included sections on sociodemographic information, mental health screening, stigma, and attitudes toward mental health service utilization.Conclusions: The BMHSUS is a reliable and culturally appropriate tool for assessing barriers to MHSU in Bangladesh. The findings highlight the importance of addressing structural, cultural, and demographic factors to improve access to mental health services. Public health interventions should reduce stigma, improve access, tailor strategies targeting specific demographic groups, and use the BMHSUS for future research and policy development.