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The protracted conflict in Yemen has led to profound disruptions in the health system, fundamentally reshaping patterns of healthcare access and utilization. This commentary engages with a recent study that conceptualizes self-medication and informal antibiotic use as forms of coping and agency in constrained settings, and re-examines this interpretation within the context of systemic collapse. Drawing on a structural perspective, the analysis argues that self-directed care practices in Yemen are not temporary responses to episodic constraints but are embedded within enduring structural conditions shaped by infrastructure destruction, workforce depletion, and disruptions in medical supply chains. These conditions have produced overlapping physical, financial, and sociocultural barriers to healthcare access, contributing to the normalization of informal care practices, including self-prescription and reliance on community-based networks. The commentary also examines the role of psychological distress in shaping health-seeking behaviour, highlighting how the absence of accessible mental health services reinforces reliance on self-directed care. By reframing self-medication as an outcome of structural conditions rather than individual choice, this analysis contributes to debates on health system collapse in conflict settings and underscores the limitations of behaviour-focused interventions while emphasizing the need to address structural determinants of healthcare access.