Pathways to care and treatment delays in first and multi episode psychosis

Temmingh, Hendrik S.; Oosthuizen, Piet

doi:10.1007/s00127-008-0358-5

Cited by 48 publications

(53 citation statements)

References 46 publications

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“…Mindful of overgeneralizations, which might ignore the uniqueness of mental health services in Africa, we note that our findings on first contact or THP/DUP relationship are consistent with previous South African (Mkize et al, 2004; Temmingh et al, 2008) and African-studies (Abiodun, 1995; Gureje et al, 1995; Gureje et al, 2006; Odinka et al, 2014; Patel et al, 1997). However, caution against causal inference or interpretation of the benefit/risk of specific types of first contact service provider (i.e.…”

Section: Discussionsupporting

confidence: 91%

Duration of Untreated Psychosis and the Pathway to Care in KwaZulu-Natal, South Africa

Tomita

Burns

King

et al. 2015

Journal of Nervous &Amp; Mental Disease

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Considerable controversy surrounds the role of traditional health practitioners (THP) as first contact service providers and their influence on the duration of untreated psychosis (DUP) in sub-Saharan Africa. This study examined first-contact patterns and pathways to psychiatric care among individuals with severe mental illness in South Africa. A cross-sectional study was conducted at a referral-based tertiary psychiatric government hospital in KwaZulu-Natal Province. Information on pathways to care was collected using the World Health Organization’s Encounter Form. General hospital was the most common first point of contact after mental disorder symptom onset and the strongest link to subsequent psychiatric treatment. Family members were the most common initiators in seeking care. First contact with THP was associated with longer DUP and higher number of provider contacts in the pathway based on adjusted regression analyses. Strengthening connections between psychiatric and general hospitals, and provision of culturally-competent family-based psychoeducation to reduce DUP are warranted.

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Section: Discussionsupporting

confidence: 91%

Duration of Untreated Psychosis and the Pathway to Care in KwaZulu-Natal, South Africa

Tomita

Burns

King

et al. 2015

Journal of Nervous &Amp; Mental Disease

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“…Of the 14 studies identified in the review, two were conducted in Ethiopia [20, 21], eight in Nigeria [22–29], three in South Africa [30–32] and one in Zimbabwe [33]. They consisted of the following populations: 11 had adult patients, one had adult caregivers of persons with mental disorders [30], one with both children and adults [20], and one with children and adolescents [27].…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, four studies examined the association between consulting traditional or religious healers as first provider and experiencing relative delays in accessing mental health services. All were conducted in populations with first-episodes of mental disorders, mainly first-episode psychosis [20, 26, 29, 32], and reported longer delays in accessing mental health services where traditional or religious healers were the initial care providers.…”

Section: Discussionmentioning

confidence: 99%

Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis

Burns

Tomita

2014

Soc Psychiatry Psychiatr Epidemiol

149

127

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Purpose-In resource-limited contexts in low-and middle-income countries (LMICs), a considerable proportion of individuals seeking care for mental disorders consult traditional and religious healers in their pathway to mental health care. Reports from Africa suggest that early involvement of healers may result in delays in the care pathway; a potential barrier to early identification and intervention.Methods-A systematic review was conducted to evaluate the proportion of patients attending formal health services after making first contact for treatment of mental disorders with traditional or religious healers or other informal and formal care providers within published research in Africa. Electronic databases were searched for the period from January 1990 to February 2014. Quality assessment of included studies was conducted the SAQOR tool.Results-Fourteen papers were identified with data on category of first care provider. Utilizing random effects modelling with inverse variance method, the pooled proportion of participants making first contact for treatment of mental disorders with two broadly categorised providers (informal and formal) was 48.1 % (95 % CI 36.4-60.0 %) and 49.2 % (95 % CI 38.0-60.4 %), respectively. The pooled proportion of participants making first contact with specific providers was: traditional healers (17.0 %, 95 % CI 10.9-24.1 %); religious healers (26.2 %, 95 % CI 18.1-35.1 %); general health services (24.3 %, 95 % CI 16.9-32.5 %); and mental health services (13.0 %, 95 % CI 5.1-23.5 %). Substantial regional variation in patterns of first provider choice was evident.

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“…The ultimate aim shall be that of making scientifically sound, acceptable, and affordable care accessible to patients. Various attempts have been made to study the pathway to care for dementia, alcohol use disorders,[11] psychiatric morbidity[12] acute renal colic,[13] post-natal depression,[14] Attention Deficit Hyperactivity Disorder (ADHD)[15] etc.…”

Section: Discussionmentioning

confidence: 99%

Pathway to care of epilepsy patients: Exploratory study from an urban slum in Northern India

Jeyashree

Sinha

Patro

2013

Ann Indian Acad Neurol

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Introduction:Epilepsy is a chronic neurological disorder with major psychosocial correlates. Most epilepsy patients in developing countries are untreated or inadequately treated. It is essential to understand the pathway, to care taken by epilepsy patients in a community, to be able to target appropriate services to them.Materials and Methods:A community based study was conducted on all epilepsy patients in an urban slum in Northern India to study their pathways to care. A list of persons suffering from epilepsy was generated by house to house visits, snowballing, and key informant contacts. In-depth interview and Medical Record Review were used to document their pathway to care.Results:Thirteen of the twenty two patients had contacted a health-care provider for their first episode. The most common first link of care for the patients was secondary level Government hospitals. The next common was private practitioners, followed by Tertiary Care Hospitals, and registered medical practitioners. Eleven out of twenty two patients had to contact a Tertiary Level Center for seeking care. The number of health-care facilities consulted before arriving at their latest point of care ranged from 0 to 5. Traditional or faith healers were consulted at some point of time for cure.Conclusion:There is a need to focus on strengthening and capacity building of the primary care settings for managing epilepsy to enable their better utilization. This shall prevent unnecessary referrals and hence the load on the already burdened higher facilities.

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Pathways to care and treatment delays in first and multi episode psychosis

Cited by 48 publications

References 46 publications

Duration of Untreated Psychosis and the Pathway to Care in KwaZulu-Natal, South Africa

Duration of Untreated Psychosis and the Pathway to Care in KwaZulu-Natal, South Africa

Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis

Pathway to care of epilepsy patients: Exploratory study from an urban slum in Northern India

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