Pathways adopted by patients visiting a psychiatric outpatient department in a tertiary care center

ABSTRACT Background: Our nation grapples with a poor understanding of mental health, and negative connotations are usually associated with the term “mental illness.” This, in turn, increases the psychiatric burden via nonacceptance of illness and subsequently resorting to circuitous routes for help. Aim: The aim of this study was to delineate the routes patients utilize when consulting a psychiatrist and the variables linked to referral delays. Materials and Methods: A semi-structured interview was used to glean sociodemographic information from 150 patients who visited the Department of Psychiatry of a tertiary care facility. ICD-10 was used to make the diagnosis. The “WHO pathways to care proforma” was used as a sample to document the pathways embarked on by patients. The pathways were depicted pictorially, and comparisons between different domains were made. Results: The majority of patients’ initial contact for care was general practitioners (36%), followed by religious healers (28%), with psychiatrists making up the minority of first-contact caregivers. Thirty-four percent had a delay of one to five years, and 44% took more than five years to visit a psychiatrist. Rather than the patients themselves, relatives were the ones who initiated help seeking (69.3%). 36.7% of the relatives decided to wait, attributing the behavioral change to extraneous influences. Sixty-eight percent of patients reached a psychiatrist after one or two referrals. This illuminates the detours taken prior to relevant treatment. Psychiatrists, quacks, general practitioners, and faith healers/priests were the main channels observed. Conclusion: Raising awareness and using stigma reduction strategies can help address care seeker delays and ensure prompt intervention and beneficial results.