Table 3. Recommendations for improving mental health service utilization at PHC facilities.

Levels	Recommendations	Narratives
Individual	Awareness	If people have awareness regarding disease condition, state of disease, knowledge about the proper treatment centers then we can empower them to visit health facilities for treatment. (Service Provider, 35 years, Male, Brahmin, Married)
Interpersonal	Awareness	For service users, if they or their family members could be assured that if they go to the health facility that their mental health problem will be solved then would they come to utilize the service. (Health Administrator, 47 years, Male, Brahmin, Married)
Organizational	Trained mental health workforce, Infrastructures, Availability of medicines	If doctors for mental illnesses were available at PHCC and Health Posts then it would be better for people of low economic status like us as we need not travel far for treatment and could get treatment easily. (Caretaker of 45 years old married Dalit female) In addition, there should be availability of separate room for counseling as well as male health staff for treating male and female health staff for treating female patients with mental illnesses should be present. (Service Provider, 35 years, Male, Brahmin, Married)
Community	Awareness	I think that people with mental illnesses should not be tagged crazy (baulaha) or should not be neglected such that they die an unknown death or hurt any other people. (Caretaker of 36 years old widowed Chhetri female)
Policy	Access to services	Had there been a hospital at our municipality we would not have come here, we would spend our money within our village, and it would be a lot easier for us and would reduce our expenses on transportation. (Patient, 36 years, Female, Dalit, Married)