Pathways to psychiatric care in Bangladesh

Noor Ahmed Giasuddin, Nafia Farzana Chowdhury, Naoki Hashimoto, Daisuke Fujisawa, Shafquat Waheed

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Introduction The pattern of care seeking of psychiatric patients is important for service and policy issues. We conducted a study in 2008 in Bangladesh to find out the referral patterns, delays to reach mental health professional (MHP), diagnoses and treatment received before reaching psychiatric care etc. Materials and methods We interviewed 50 consecutive new patients at the Psychiatry outpatient department of a tertiary hospital using the translated version of WHO pathway encounter form. Results 84% of the patients we interviewed consulted other carers before they arrived at a MHP (2.5-3.1 steps were needed to reach MHP) and the range of delay was 8-78 weeks (indirect pathway). 16% of the patients came directly to a MHP with mean delay of 10.5 weeks from onset of mental illness (direct pathway). Among the patients who took the indirect pathway 44% first visited the Individual Private practitioners (PP), 22% first visited native or religious healers (NRH) and 12% rural medical practitioners (RMP). Patients reaching NRH or RMP made the least delay (2-2.5 weeks) and the shortest pathway to MHP (4.5-7 weeks). Most delay occurred from PP to MHP/General Hospital (22-31 weeks). About a third of patients were informed of diagnosis with poor concordance with the diagnosis made by MHP. 70 and 40% of patients with mental illness who attended General Hospital and PP were referred to MHP, respectively. Conclusion 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.

Original languageEnglish
Pages (from-to)129-136
Number of pages8
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume47
Issue number1
DOIs
Publication statusPublished - 2012 Jan
Externally publishedYes

Fingerprint

psychological care
Bangladesh
Psychiatry
health professionals
Mental Health
mental health
General Hospitals
mental illness
Referral and Consultation
Mentally Ill Persons
WHO
psychiatry
Tertiary Care Centers
Caregivers
Health Services
family member
health service
Outpatients

Keywords

  • Bangladesh
  • Mental health
  • Pathway
  • Pathway to mental health care
  • Psychiatric care

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Epidemiology
  • Health(social science)
  • Social Psychology

Cite this

Pathways to psychiatric care in Bangladesh. / Giasuddin, Noor Ahmed; Chowdhury, Nafia Farzana; Hashimoto, Naoki; Fujisawa, Daisuke; Waheed, Shafquat.

In: Social Psychiatry and Psychiatric Epidemiology, Vol. 47, No. 1, 01.2012, p. 129-136.

Research output: Contribution to journalArticle

Giasuddin, NA, Chowdhury, NF, Hashimoto, N, Fujisawa, D & Waheed, S 2012, 'Pathways to psychiatric care in Bangladesh', Social Psychiatry and Psychiatric Epidemiology, vol. 47, no. 1, pp. 129-136. https://doi.org/10.1007/s00127-010-0315-y
Giasuddin, Noor Ahmed ; Chowdhury, Nafia Farzana ; Hashimoto, Naoki ; Fujisawa, Daisuke ; Waheed, Shafquat. / Pathways to psychiatric care in Bangladesh. In: Social Psychiatry and Psychiatric Epidemiology. 2012 ; Vol. 47, No. 1. pp. 129-136.
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