A cross sectional study of pathway to psychiatric care in patients with first episode schizophrenia spectrum and other psychotic disorders.

BACKGROUND: Psychotic disorders carry a substantial burden on public health. There is divergence between high burden of mental illness and comparatively low likelihood of obtaining treatment. Hence, concept of pathway to care is being studied where the help seeking behaviour of patient and family; subsequent accessibility to health care services are evaluated. AIM: To find out pathways of help-seeking behaviour and to assess the association of socio-demographic, clinical and health care service factors with pathway of care of patients with psychotic spectrum disorders. METHODOLOGY: A cross sectional study was conducted on patients presenting to psychiatry OPD, KIMS, Hubballi diagnosed with schizophrenia and other psychotic spectrum disorders (as per ICD 10, F20-29). A semi-structured proforma was used to obtain socio-demographic, clinical details of the patient based on WHO encounter form. RESULTS: A total of 60 cases of first episode psychosis were assessed. Mean age of the patients was 33.87±10.94 years. Majority of them were females, belonged to rural background and were married. Mean duration of psychotic illness was 7.5 months. Majority of them 55% had first contact with a faith healer. Only 18.3% had their first contact to a psychiatrist. On an average, the first contact ever was initiated after 2 months of illness onset. CONCLUSION: Referral to psychiatric services is often delayed leading to increased duration of untreated psychosis and burden of care. The service providers and policy makers’ needs to be sensitised about appropriate and accessible psychiatric services, providing easy and favourable pathway of care for psychiatric patients.