Barreiras ao acesso aos serviços de saúde mental na atenção primária à saúde em contextos rurais: revisão integrativa da literatura

Abstract

Mental health is an essential component of human well-being, influenced by social, cultural, and economic factors, particularly in rural contexts. Despite the strategic role of Primary Health Care (PHC) as the main entry point for care, access to mental health services among rural populations remains limited. This study aimed to identify barriers to accessing mental health services in PHC among rural populations. This is an integrative literature review conducted based on the methodological framework of Souza, Silva, and Carvalho and guided by PRISMA recommendations. The literature search was performed in LILACS, MEDLINE/PubMed, Web of Science, PsycINFO, and Scopus databases, including studies published between 2021 and 2025. A total of 10 studies were included in the final sample. Findings indicate that access is influenced by interconnected sociocultural, structural, and individual barriers. The main barriers identified include stigma associated with mental illness, fear of social judgment, concerns about confidentiality, cultural and religious beliefs, gender norms, social vulnerabilities, and low perceived need for care. These factors contribute to delayed or absent utilization of services, exacerbating mental health inequalities. It is concluded that strengthening PHC strategies focused on health education, stigma reduction, confidentiality assurance, and culturally sensitive approaches is essential to expand access and promote equity in mental health care for rural populations.