In the study we found four major pathways to mental health care in Bangladesh. They are direct pathway and referrals from PP, general hospitals and NRH. PP did not play a pivotal role in reaching MHP. Family members had a significant role on the decision to seek help from health service.

The relative improvement in attitudes toward psychiatry in the upper medical school year is overshadowed by the increased stigma toward PMDs. Specific anti-stigma program in the curriculum and strategies to improve the attitudes are required.

Studies of pathways to MHC in Asian countries are feasible and can provide data of interest in the organization of care.

BackgroundIdentification of prior mental events of suicide attempts has immense importance in suicide prevention. However, it has not been studied in Bangladesh as there was no available psychometrically valid instrument measuring it.ObjectivesWe aimed to test the psychometric properties of the interpersonal needs questionnaire (INQ-15) and acquired capability for suicide scale-fearlessness about death (ACSS-FAD) in Bangla along with the determination of the level of thwarted belongingness, perceived burdensomeness, and acquired capability for suicide.Materials and methodsWe collected data between 29 March and 14 April 2022 from 1,207 students of medical colleges and universities in Bangladesh by Google form. We assessed the psychometric properties of Bangla INQ and ACSS-FAD scales and examined factors associated with thwarted belongingness, perceived burdensomeness, and acquired capability for suicide.ResultsThe mean age of the participants was 22.82 ± 1.68 (range 18–29) years, 51% were females, 84% were graduate students, and 92% were unmarried. Both of the scales revealed acceptable levels of reliability. Confirmatory factor analysis revealed a two-factor structure of Bangla INQ after dropping three items from thwarted belongingness domain (item 9, 11, and 12) and a single factor structure for Bangla ACSS-FAD after dropping three items (item 1, 4, and 6). Perceived burdensomeness was significantly higher in females, students with a history of mental illness, family history of suicide, and the history of suicidal attempts. Fearlessness about death was significantly higher among females, non-Muslim participants, and history of suicidal attempts.ConclusionThe current study revealed psychometric properties of two suicide scales (INQ and ACSS-FAD) in Bangla that can be used in subsequent studies. Prevention strategies targeting to females, persons with psychiatric disorder, history of previous attempt(s) should be prioritized specially among the young age group.

Bangladesh has only one mental hospital which is situated in Pabna district of the country. People from the nearby locality as well as from distant regions of the country come here for psychiatric service. Clinical records of all the children who attended the outpatient department of 'Mental Hospital, Pabna' (MHP) during January, 2009 to June, 2009 were analyzed. Of the 143 children, 125 (88%) were of school going age (i.e., ?6 years of age). The majority (63%) of the patients were male. International Classification of Diseases (ICD) classification revealed that the patients came with mental retardation (F70-F79) (38%), Episodic and paroxysmal disorder (G43-G44) (26%) and Schizophrenia, schizotypal & delusional disorders (F20-F29) (22%). The main comorbid condition was behavioural problem with mental retardation (43% of mentally retarded). Of the 103 patient we had information about the   pathway to care, 20 patients (19%) came directly to MHP and the rest 83 (81%) consulted other service provider before reaching here. Among the previous service providers, there were medical graduates (60%), Kobiraj (36%) and indigenous & religious healer (34%). Considering the variety of presentation of child and adolescent patients, we   propose to establish a multidisciplinary approach in MHP. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13501 Faridpur Med. Coll. J. 2012;7(2):67-70