Duration of untreated illness, India, Pathway, Traditional healers
Citation Information :
Simiyon M, Joju S, Thilakan P, Mani M. How Lengthy and Tortuous is the Pathway to Psychiatric Care among Patients Visiting a Tertiary Care Hospital in South India? A Cross-sectional Study. Ind J Priv Psychiatry 2022; 16 (1):3-9.
Background: Mental illnesses (MI) are commonly linked with a higher burden of disease. A large number of patients with mental illnesses do not present to the mental health services directly rather they adopt a pathway that is usually prolonged and tortuous. By the time they reach the mental health services the illness becomes chronic and the resources are exhausted. It is all the more relevant in countries like India where traditional healing practices are easily accessible in contrary to mental health services.
Aims and objectives: The aims and objectives of this study were to measure the number of encounters patients with psychiatric illnesses had before meeting a mental health professional and the duration of untreated illness (DUI).
Materials and methods: In this cross-sectional questionnaire-based study, we interviewed 150 patients and their caregivers visiting the outpatient services of a tertiary care teaching hospital in South India.
Results: The median time taken for any help, from traditional healers, general hospitals, or a mental health practitioner was 12 months (IQR 2–47.25). The median DUI was 18 months (IQR 2.75–60), and the median total duration of illness was 24 months (IQR 4–87). The mean number of encounters was 2.7 (SD ± 1.77). As the first point of contact, 12% had met a traditional healer and 40% had met a psychiatrist. Friends and relatives in 80% of the patients initiated help-seeking. In multivariate analysis, age, male gender, and lower educational status were significant predictors for a longer duration of illness.
Conclusion: Patients in India continue to take a long and tortuous pathway to psychiatric care that goes through many encounters.
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