Pathways of Psychiatric Treatment in Rural Patients with Psychosis

Abstract

Background: Pathways of care support the development of care partnerships and empower patients and their care providers along with necessary modifications in the existing health services. Aim: To examine the various pathways of psychiatric treatment in rural patients with psychosis and to know the source of referral, first contact for treatment, awareness about the signs and symptoms and various symptoms (complains) with which the patients presented themselves to the different modalities of treatment. Methods: It was a cross sectional hospital based study conducted at Out-Patient Department of Ranchi Institute of Neuro-Psychiatry & Allied Sciences (RINPAS) Kanke, Ranchi. Purposive sampling technique was used for the study, total 96 participants were selected in 1 month duration. Subjects were evaluated using socio demographic datasheet, WHO counter form and BPRS-24. Results: The present study found that the mean duration of untreated psychosis was 558.80±707.08 days. First symptoms appeared at onset of illness, in which fearfulness (13.5%) appeared in most patients. Time taken to decide to go for consultation after onset of illness was 417.67±621.11 days. Maximum first consultations were to native & faith healers (69.8%) and only 17.7% consulted psychiatric services at first contact. For the first referral, 64.6% patients shifted to psychiatric services from other modes such as native / faith healer, general hospital and medical practitioner. CONCLUSION: The study provides an insight into the nature of the pathway and referral taken by rural patients with psychosis and their caregivers.

Key Words: Pathways, Psychiatric treatment, rural patients.