Barriers to mental healthcare seeking among individuals attending primary healthcare centers in Riyadh, Saudi Arabia

BACKGROUND: Mental health conditions remain a major global public health concern. Despite national efforts to integrate mental health services into primary healthcare (PH) in Saudi Arabia, its utilization remains limited. Understanding stigma-related and nonstigma-related barriers is essential to improving access and informing service development. MATERIALS AND METHODS: A cross-sectional survey was conducted between April and August 2025 among Saudi adults attending PH centers (PHCs) in Riyadh. Participants were recruited through convenience sampling; data was collected using a validated self-administered questionnaire in Arabic. Barriers to Access to Care Evaluation (BACE-III) scale was used to measure stigma and nonstigma barriers. Initial analysis included descriptive statistics; t-tests and ANOVA were used to compare the mean stigma and nonstigma domain scores, and multiple linear regression was performed to determine predictors of perceived barriers. Reliability of the BACE-III in this sample was high (Cronbach’s α = 0.956). RESULTS: A total of 416 participants were surveyed. Younger age, lower educational level, and student status were associated with significantly higher stigma and nonstigma barrier scores ( P < 0.001). Awareness of the availability of mental health services in PHCs was strongly associated with lower perceived barriers ( P < 0.001). No significant differences based on gender, health insurance status, or prior experience with mental health services were observed. Regression analyses showed that age and awareness independently predicted perceived barriers. CONCLUSION: Stigma-related and nonstigma-related barriers continue to impede utilization of mental health services in PH settings. Increasing public awareness, affirming the assurance of confidentiality, and implementing community-level antistigma initiatives may improve equitable access and support the goals of the Saudi Vision 2030 health transformation.