Pathways to severe mental illness care: A retrospective study of patients seeking psychiatric care at Department of Psychiatry, AIIMS, Delhi

Background and aim: Globally, very few patients with mental illness go to health care facilities to receive psychiatry treatment. This study aims to identify pathways used by patients with severe mental disorders who seek mental health care services in the psychiatry unit of AIIMS, New Delhi. Materials and methods: It is a retrospective cross-sectional study with convenience sampling technique was used, and data were collected from 123 caregivers of patients with severe mental illnesses using standardized tools like MINI, BPRS, YMRS and WHO Encounter pathway. Results: The findings revealed that 41.5% of the patients made their first contact with the faith healers, 27.6% with AYUSH medical practitioners, 14.6% with psychiatrists and 12.2% with allopathic medical practitioners. About 26% of the patients reported hallucinations as the first symptom for seeking help. In the majority of cases (96.7%), the patient's relatives made the decision for the patient to seek treatment the first time to manage the symptoms. The psychotic symptoms (65.1%) helped the patient's relatives to take the decision for first seek. The mean delay for seeking treatment from psychiatrists was 13.31 +/- 10.6 (months). Conclusion: This study showed that a higher proportion of patients received treatment from the faith healer at the first seek, whereas only a few patients approached psychiatrist directly. Hence, there is an immense need to create awareness regarding mental illness and treatment options available.