" I don't care about my mental health because I have a physical disability": A qualitative study on the mental healthcare-seeking behaviours of people with disabilities in Bangladesh

In Bangladesh, people living with disabilities are one of the most vulnerable groups, as they receive little or no assistance. They face numerous challenges regarding financial, social, and access to basic education and healthcare, which contribute to experiences of distress and mental health issues. However, there is limited research on the mental health needs of people with disabilities and the accessibility of mental health services in Bangladesh. This qualitative study addresses this gap by examining the mental healthcare-seeking behaviours of people with disabilities and challenges in care-seeking pathways and recommendations for devising an inclusive system in existing mental health services through key informant interviews and focus group discussions with 55 participants from four stakeholder groups. Findings highlight that limited mental health, literacy, stigma, and financial and logistical challenges, such as inaccessible transportation and distant facilities, hinder access to care. System-level barriers, including a lack of specialists and inadequate community-based services, further exacerbate the issue. Stakeholders recommended strengthening social support systems by providing disability identity cards, allowances, and access to inclusive education and employment opportunities. They also emphasized the need for awareness campaigns, better transportation options, and training for healthcare workers. Policymakers are urged to design culturally relevant needs-based interventions to improve mental healthcare pathways for people with disabilities while promoting multisectoral collaboration.