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.

A cross-sectional descriptive type of study on 357 patients was carried out in the emergency departments of Dhaka Medical College Hospital (DMCH) and Shahid Sohrawardy Medical College (SSMCH), Dhaka in 2011 to find out the incidence and socio-demographic characteristics of psychiatric morbidities among the patients attended there. The patients were interviewed using GHQ-28 and SCID-I, All GHQ-28 screen positive and 25% of screen negative respondents (total 158) were assessed by SCID-I. Among them 42 (11.76% of all 357 cases) respondents were found with some form of psychiatric illness. Diagnosis of psychiatric illness was significantly higher in those scored 4 or more in GHQ-28. More psychiatric cases were found among 18-25 years age group (50%), male gender (54.76%), urban population (69.05%), Muslims (85.71%), being single (54.76%), patients with secondary level of education (45.24%), housewives (26.19%), members of nuclear families (78.57%), and members of lower-income group. Among these 42 psychiatric cases, 22 were assessed by a psychiatrist who was blind about GHQ-28 score and SCID-I diagnosis. Out of these psychiatrically ill 42 cases, Major Depressive Disorder was in 9 (2.52% of the total study population of 357), Conversion Disorder was in 8 (2.24%) and Anxiety Disorder was in 7 (1.96%) respondents. There were two cases of Bipolar I Disorder and a single case of extrapyramidal side effects (EPSEs) with schizophrenia. Psychiatric illnesses are important issues at the emergency departments which require special attention. Bang J Psychiatry June 2017; 31(1): 7-14