Introduction
Depression is a major public health problem worldwide, with a 9% prevalence among Dutch adults. Around 70% of individuals experiencing depressive symptoms do not seek timely help, increasing the risk of major depressive disorder (MDD) and long-term problems. Identifying barriers and facilitators may support earlier intervention and improve public mental health.


Method
We conducted semi-structured interviews with 18 participants from Rotterdam area (the Netherlands). Transcripts were thematically analysed by two independent researchers using inductive coding, with overarching themes for barriers and facilitators derived from the data and stratified by demographics (age, gender, education, and cultural background) and by frequencies of mentions at the individual level.


Results
Among the 18 participants (11 woman, ages 18-86, 61.1% Western European), all reported barriers and facilitators, and six overacting themes of barriers and facilitators were identified. Stigma and self-stigma were the most common barriers (88.9% of 18 participants), followed by systemic issues (88.3%), knowledge and literacy (77.8%), accessibility/affordability (77.8%), psychological/illness-related barriers (66.7%), and cultural barriers (61.1%). Demographic differences showed that men more often cited knowledge gaps and cultural norms as barriers for help-seeking while woman emphasised accessibility and systemic issues (e.g. waiting lists or trust in Dutch healthcare). Younger adults highlighted stigma, while psychological barriers were most frequently mentioned by older adults. The most frequently proposed facilitators were improving knowledge/awareness (88.9% of 18 participants), systemic improvements (66.7%), stigma reduction (61.1%), professional training and communication (44.4%), peer/community support (22.2%), and better screening(16.7%).


Conclusion
Although primary care in the Netherlands is freely accessible, stigma, systemic barriers, and knowledge gaps still delay timely help-seeking for depressive symptoms. Targeted strategies, such as addressing knowledge gaps particularly among men and systemic improvements for women, may promotor earlier intervention. Increasing awareness and building more trust in healthcare providers are key areas for future prevention efforts and improve mental health outcomes.