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ORIGINAL ARTICLE
Year : 2021  |  Volume : 37  |  Issue : 4  |  Page : 423-429

Accessing mental health care among people with schizophrenia: Data from an Indian rural psychiatric setting


1 Center for Community Mental Health (CCMH), Mangalore, Karnataka, India
2 Young Indian Fellowship Program, Ashoka University, Haryana, India
3 Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
4 Department of Psychiatry, K.S. Hegde Medical Academy, Mangalore, Karnataka, India
5 Department of Psychiatry, Manipal University, Manipal, Karnataka, India
6 Department of Psychiatry, MIMER Medical College, Pune, Maharashtra, India
7 Nitte Rural Psychiatric Project, Mangalore, Karnataka, India

Correspondence Address:
Dr. Anish V Cherian
Associate Professor, Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka 560 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijsp.ijsp_141_20

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Background: “Duration of untreated psychosis” (DUP) remains a major predictor of poor outcome among people with schizophrenia (SCZ). Reducing DUP remains a challenging public health concern. Studies from various low- to middle-income countries demonstrate that many patients with SCZ remain untreated for long, especially in rural communities. However, there is paucity of data from rural India on DUP and pathways to care. Methodology: We consecutively recruited 106 patients registered at a rural psychiatric center in South India who met the International Classification of Disorders-10 criteria for SCZ. The delay from the onset of psychotic symptoms to seeking psychiatric help was measured and the pathways to care were assessed. Results: The patients were nearly equally distributed across the genders and were predominantly <40 years of age from rural and low- to middle-income backgrounds. The mean and median DUP were 3.15 ± 5.61 years and 1 year (interquartile range = 2.79), respectively. Although the longest time to contact was 28.5 years, 80% had DUP shorter than 5 years. Three major gateways to care were identified, with native/faith healers being the most popular (73.58%). Conclusion: In rural India, patients with SCZ tend to take longer to seek psychiatric help after their first psychotic episode compared to urban counterparts. Our results emphasize the necessity of developing early identification, improving mental health literacy, and providing community-based interventions for people with SCZ.


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