Title: Pathways to Psychiatric Care: A Hospital Based Study

Authors: Narayan R Mutalik, Khushboo Dewani, Shriniwas B Choudhari

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i4.138

Abstract

Background: Neuropsychiatric disorders account for about 14 % of the global burden of disease.Many people living with mental disorders delay seeking psychiatric care from formal health facilities.This delay is there because of various factors. A lack of knowledge about psychiatric disorders remain major barrier to mental health care. An understanding of the way people seek care for mental disorders is important for planning mental health services, and referral from other sectors of health and social care. Keeping these in mind, this study was conducted to determine prior care seeking pathways of new patients reporting to psychiatry out-patient department.

Methodology: A descriptive study comprising of 50 subjects attending psychiatry de-addiction clinic in a private medical college in Bagalkot, Karnataka during 1st November2016 to 31st December 2016 was done after taking institutional ethical committee clearance. A World Health Organization (WHO) pathways to care proforma was used to determine the socio-demographic details of patients. Pathway prior to care taking and treatment were determined. Statistical analysis using appropriate statistical tests were used.

Results: Majority (36%) of patients first contacted medical practitioners, followed by psychiatrists and faith healers. Average delay of 44.14 months was found in reaching psychiatric services.

Conclusion: Creating awareness among general population could address cultural myths and stigma related to mental illnesses and thus help in improving treatment seeking behavior.

References

1.      World Health Organization. International Consortium in Psychiatric Epidemiology. Cross-national comparisons of the prevalences and correlates of mental disorders. Bull World Health Organ. 2000;78(4):413-26.

2.      National Institute of Health and Family Welfare. National Mental Health Program. New Delhi: NIHFW; 2005. Accessible from: http://www.nihfw.org/ ndc-nihfw/html/Programmes/NationalMentalHealth.htm [Last accessed on 2007 Jul 12].

3.      Kohn R, Saxena S, Levav I, Saraceno B. The treatment gap in mental health care. Bull World Health Organ. 2004 Nov;82(11):858-66.

4.      Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A. No health without mental health. Lancet. 2007 Sep 14;370(9590):859-77.

5.      Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997 May 3;349(9061):1269-76.

6.      Ibrahim A, Hor S, Bahar OS, Dwomoh D, McKay MM, Esena RK, Agyepong IA. Pathways to psychiatric care for mental disorders: a retrospective study of patients seeking mental health services at a public psychiatric facility in Ghana. Int J Ment Health Syst. 2016 Oct 3;10(1):63.

7.      Kurihara T, Kato M, Reverger R, Tirta IG. Pathway to psychiatric care in Bali. Psychiatry Clin Neurosci. 2006 Apr 1;60(2):204-10.

8.      Thirunavukarasu M, Thirunavukarasu P. Training and National deficit of psychiatrists in India-A critical analysis. Indian J Psychiatry. 2010 Jan 1;52(7):83.

9.      Rogler LH, Cortes DE. Help-seeking pathways: a unifying concept in mental health care. Am J Psychiatry. 1993 Apr 1;150(4):554.

10.  Naik SK, Pattanayak S, Gupta CS, Pattanayak RD. Help-seeking behaviors among caregivers of schizophrenia and other psychotic patients: a hospital-based study in two geographically and culturally distinct Indian cities. Indian J Psychol Med. 2012 Oct 1;34(4):338.

11.  Lahariya C, Singhal S, Gupta S, Mishra A. Pathway of care among psychiatric patients attending a mental health institution in central India. Indian J Psychiatry. 2010 Oct 1;52(4):333.

12.  Mishra N, Nagpal SS, Chadda RK, Sood M. Help-seeking behavior of patients with mental health problems visiting a tertiary care center in north India. Indian J Psychiatry. 2011 Jul 1;53(3):234.

13.  Chadda RK, Agarwal V, Singh MC, Raheja D. Help seeking behaviour of psychiatric patients before seeking care at a mental hospital. Int J Soc Psychiatry. 2001 Dec;47(4):71-8.

14.  Alegría M, Bijl RV, Lin E, Walters EE, Kessler RC. Income differences in persons seeking outpatient treatment for mental disorders: a comparison of the United States with Ontario and The Netherlands. Arch Gen Psychiatry. 2000 Apr 1;57(4): 383-91.

Corresponding Author

Dr Narayan R Mutalik   M.D (NIMHANS)
Assistant Professor, Department of Psychiatry,Staff Quarters. C-35, 
S.N.Medical College & HSK Hospital & MRC, Navanagar, Bagalkot-587102

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile No: +91-9901621771