Factors affecting the duration taken to present to the National Institute of Mental Health (NIMH) after an acute episode of schizophrenia

Background: Longer duration of untreated/inadequately treated psychosis in schizophrenia is associated with poor long-term prognosis. Study was conducted in a period when country was facing the COVID-19 pandemic affecting many aspects of the people’s lives.Aim: This study aimed to estimate the duration taken to present to the NIMH and the demographic, socio-cultural and clinical factors associated with duration taken to present to NIMH, after an acute episode of schizophrenia. Also to identify the reasons for that duration as reported by patients and relatives.Method: This was a descriptive cross-sectional study done on 139 patients, aged between 18-60 years, admitted to NIMH with an acute episode of schizophrenia. An interviewer administered questionnaire and Brief Psychiatric Rating Scale (BPRS) were used for data collection.Results: Mean duration taken to present to the NIMH after onset of an acute episode of schizophrenia was 12-49 months. Living condition, illness course, patients and relatives believing supernatural causes as the reason for the symptoms, relatives not believing symptoms as due to a mental illness, unavailability of additional support and fear of infecting COVID in hospital premises have significant associations with duration taken to present to NIMH after an acute schizophrenia episode.Conclusion: Steps to activate the new mental health act, increasing mental health awareness in the community and more community services supporting decentralization of the psychiatric services will act to reduce the duration taken to present to the NIMH after onset of an acute episode of schizophrenia improving the long-term prognosis.