Pathways to psychiatric care and factors associated with delayed help-seeking among patients with mental illness in Northern Ethiopia: a cross-sectional study

Abstract

ObjectiveThis study aimed to assess pathways to psychiatric care and factors associated with delayed help-seeking among patients with mental illness in Northern Ethiopia using the WHO Pathway Study Encounter Form.DesignA cross-sectional study design was used.SettingData were collected using face-to-face interview from patients with various diagnoses of mental illness attending outpatient treatment at Ayder Comprehensive Specialized Hospital in Mekelle City, Tigray, Northern Ethiopia.ParticipantsParticipants who came to attend outpatient treatment during the study period were included in the study using consecutive sampling technique.Outcome measuresPathways to psychiatric care, delayed psychiatric treatment and factors affecting delayed psychiatric treatment.ResultsThe median duration from problem onset to contact with first care provider was 4 weeks, whereas contact with modern psychiatric services was 52.0 weeks. Study participants who were single (adjusted OR (AOR)=2.91, 95% CI 1.19 to 7.11), divorced (AOR=3.73, 95% CI 1.33 to 10.49) and who perceived mental illness as shameful (AOR=3.29, 95% CI 1.15 to 9.41) had delayed treatment-seeking behaviour, whereas participants with no history of substance use (AOR=0.43, 95% CI 0.20 to 0.92) were less likely to have delayed treatment-seeking behaviour.ConclusionsThere is significant delay in seeking modern psychiatric treatment. Religious healers were the first source of help for mental illness. Majority of the respondents described that mental illness was due to supernatural causes. Stigma and lack of awareness about where treatment is available were barriers to seeking appropriate care.

Patterns of help-seeking behavior among people with mental illness in Ethiopia: a systematic review and meta-analysis

“…Regarding geographical region, five studies ( 4 , 38 , 40 , 43 , 45 ) were conducted in Oromia, five ( 41 , 44 , 48 , 50 , 52 ) in Amhara, five ( 39 , 42 , 46 , 47 , 49 ) in the SNNPR, and one ( 51 ) in the Tigray region ( Table 1 ).…”

Mapping resources available for early identification and recovery-oriented intervention for people with psychosis in Addis Ababa, Ethiopia

“…In an old study conducted at the main psychiatric hospital, Amanuel Specialized Mental Hospital, only 41% of service users came directly to the hospital, with the remaining trying alternatives first (13). In Ethiopia, people with psychosis and their families commonly seek out biomedical mental healthcare services after investing a substantial amount of time and money in alternative places (13, 14, 36). This concern was also raised by the stakeholders in our Theory of Change workshop.…”

“…lack of available, accessible and adequate mental health services) (11, 12). Consequently, help-seeking pathways are often convoluted and may involve multiple contacts with traditional and/or faith healers or non-specialist healthcare providers before accessing mental health services (13, 14). Even when mental health services are accessed, engagement is often intermittent and poorly coordinated with pluralistic approaches to care (15, 16).…”

Exploring sustainable care pathways.

“…Of the twelve articles with qualitative data, the aims were as follows: understand the contextual in uences, mechanisms and outcomes that affect the implementation of online pathways (Akehurst et al, 2018) evaluate how the 'payment by result' model works in community mental health, including its impact on the quality of patient care, staff and primary care (Khandaker et al, 2013) assess the extent to which pathways support or inform the creation of elements of frameworks to improve care coordination across the primary hospital care continuum (Van Houdt et al, 2013) explore the nature of service user involvement in the admission and discharge processes of acute inpatient mental health care (Wright et al, 2016) gain a better understanding of the transition phase from psychiatric hospitalization back to community for people diagnosed with schizophrenia(Hasson-Ohayon et al, 2016) identify patients and healthcare professionals challenges and barriers in the transitional process between primary to secondary mental health services (Sather et al, 2016(Sather et al, , 2018(Sather et al, , 2019 and determine whether implementation of a pathway would improve diagnosis and treatment in conformity with published guidelines (Teshager et al, 2020).…”