Clinical profile of patients seeking services at urban community psychiatric services in Chandigarh

CONTEXT: About two-third of patients with mental, neurological, and substance use disorder in India do not get adequate treatment due to insufficient clinical facilities. In a country with diverse population such as India, no single model can be effective and each region needs to develop local system of service delivery unique to population needs. Community outreach clinics (COCs) being run by the department of psychiatry provide mental health services in the primary health-care setting. The study reports on the pattern of service utilization across different COCs in Chandigarh. AIMS: The aim of this study was to describe the sociodemographic and clinical profile of patients seeking mental health-care services from COCs and to compare this with patients seeking care at tertiary care center. SETTINGS AND DESIGN: This was a cross-sectional case record review. SUBJECTS AND METHODS: Community services are provided in the areas adjoining Chandigarh, through four COCs: Civil Dispensary, Dhanas; Khuda Ali Sher; Rural Health Training Center, Palsaura; and Police Dispensary Sector 26 by Department of Psychiatry, Government Medical College and Hospital, Chandigarh. The current study reports on sociodemographic and clinical profile of 728 patients seen in these clinics from July 2010 to June 2011. STATISTICAL ANALYSIS USED: Descriptive statistics were performed using SPSS version 16.0. Chi-square test was used to compare two groups, ANOVA for comparing more than two groups. RESULTS: Out of the 728 patients, majority were males in productive age group with diagnosis of substance use disorder. Majority were reaching the clinics on their own and only a few were referred by various community referral agencies. Only twelve patients needed referral to the Department of Psychiatry in the above mentioned period. CONCLUSIONS: Patients of substance use disorder prefer to be seen in the outreach clinics and it is possible to manage them in these clinics with very little need to refer them to tertiary care hospitals.