TITLE

Pathways to psychiatric care in Bangladesh

AUTHOR(S)
Giasuddin, Noor; Chowdhury, Nafia; Hashimoto, Naoki; Fujisawa, Daisuke; Waheed, Shafquat
PUB. DATE
January 2012
SOURCE
Social Psychiatry & Psychiatric Epidemiology;Jan2012, Vol. 47 Issue 1, p129
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: The pattern of care seeking of psychiatric patients is important for service and policy issues. We conducted a study in 2008 in Bangladesh to find out the referral patterns, delays to reach mental health professional (MHP), diagnoses and treatment received before reaching psychiatric care etc. Materials and methods: We interviewed 50 consecutive new patients at the Psychiatry outpatient department of a tertiary hospital using the translated version of WHO pathway encounter form. Results: 84% of the patients we interviewed consulted other carers before they arrived at a MHP (2.5-3.1 steps were needed to reach MHP) and the range of delay was 8-78 weeks (indirect pathway). 16% of the patients came directly to a MHP with mean delay of 10.5 weeks from onset of mental illness (direct pathway). Among the patients who took the indirect pathway 44% first visited the Individual Private practitioners (PP), 22% first visited native or religious healers (NRH) and 12% rural medical practitioners (RMP). Patients reaching NRH or RMP made the least delay (2-2.5 weeks) and the shortest pathway to MHP (4.5-7 weeks). Most delay occurred from PP to MHP/General Hospital (22-31 weeks). About a third of patients were informed of diagnosis with poor concordance with the diagnosis made by MHP. 70 and 40% of patients with mental illness who attended General Hospital and PP were referred to MHP, respectively. Conclusion: In the study we found four major pathways to mental health care in Bangladesh. They are direct pathway and referrals from PP, general hospitals and NRH. PP did not play a pivotal role in reaching MHP. Family members had a significant role on the decision to seek help from health service.
ACCESSION #
70068399

 

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