Pathway to psychiatric care in a tertiary mental health facility in Jaipur, India

PurposeThis study was planned to evaluate the pathway to care of mentally ill patients attending a tertiary mental health facility in Jaipur to highlight the difficulties of mentally ill and their relatives in accessing appropriate care.MethodsSeventy-six patients, who attended the Out Patient Department of Psychiatry of a tertiary care hospital in Jaipur, India for the first time, were enrolled in this study. The family members of the patients were interviewed to evaluate the pathway to care using the Encounter form developed by the WHO.ResultsThe patients were predominantly young adults, male, from rural, agrarian but educated background and a majority of them presented with psychotic illnesses. It was seen that there were five major gateways to care of the mentally ill in the region, Faith healers being the most popular portal of care. The median duration of untreated illness (DUI) was 6 months, and subjects had already visited, 2 carers before visiting any mental health professional. The median monetary cost of the pathway was Rs. 3565. Patients suffering from psychotic illnesses presented earlier. Those who used psychiatric services as first portal of care had different socio-demographic variables as compared to clients who used other services.ConclusionThis pathway to psychiatric care study in Jaipur, India demonstrated that referral pathway heavily relies on faith healers. The study indicates possible fields and gives indications, underlining the importance of improving awareness campaigns that will facilitate the recognition of psychiatric disorders.

► The study evaluates the pathway to psychiatric care in patients in Jaipur, India.
► Patients adopt a pathway which traverses through many agencies, resulting in delay of treatment and chronicity.
► Faith healers dominate the pathway.
► Patients using psychiatric services as first portal have different socio-demographic and symptom profile.