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Factors influencing access to psychiatric treatment in persons with schizophrenia: A qualitative study in a rural community.

Reddy SK, Thirthalli J, Channaveerachari NK, Reddy KN, Ramareddy RN, Rawat VS, Narayana M, Ramkrishna J, Gangadhar BN - Indian J Psychiatry (2014)

Bottom Line: In low and middle-income countries, about 80% of those who need mental health services do not receive them.In addition to the well-known factors, many hitherto less-understood factors (e.g., families' conflicts, dynamics, resilience and acceptance, and community support, etc.) were identified which prevented patients and their families from seeking treatment.These findings have important policy implications.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.

ABSTRACT

Purpose: In low and middle-income countries, about 80% of those who need mental health services do not receive them. Reasons for this have not been systematically studied. In this qualitative study, we explored this issue in a rural community of South India among schizophrenia patients.

Materials and methods: Patients who had never sought psychiatric treatment despite long-standing psychotic illnesses were identified as part of a community intervention program. In-depth interviews were conducted with patients' caregivers to understand factors preventing them seeking psychiatric treatment. Interviews were audio-recorded and transcribed. Reasons cited by family members were listed and grouped into factors based on themes. Interview process was iteratively followed till no new factor emerged. Sixteen caregivers were thus interviewed.

Results: Content analysis brought out 75 reasons, which were further grouped under the following 15 factors [n (%)]: Lack of awareness about the illness: 15 (93.75%); lack of family support: Nine (56.25%); religious attributions: Nine (56.25%); financial constraints: Six (37.5%); family dynamics: Seven (43.75%); family's tolerance: Seven (43.75%); lack of insight: Five (31.25%); families resilience: Four (25.0%); community beliefs regarding mental illnesses: Four (25%), and others. In each patient, a complex interplay of several of these factors precluded the family from seeking psychiatric treatment.

Conclusions: In addition to the well-known factors, many hitherto less-understood factors (e.g., families' conflicts, dynamics, resilience and acceptance, and community support, etc.) were identified which prevented patients and their families from seeking treatment. These findings have important policy implications.

No MeSH data available.


Related in: MedlinePlus

Complex interplay of reasons for Mrs. G to remain untreated
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Figure 2: Complex interplay of reasons for Mrs. G to remain untreated

Mentions: Multiple factors preventing each patient's access to treatment should be considered while planning programs that attempt to bring all patients with psychoses under treatment. For instance, making treatment available locally may address the issue about distance and transport factors, but would do little to overcome the reasons posed by lack of awareness, family dynamics, family support, etc., This may result in many patients remaining untreated even if treatment is made available in primary health centers as is envisaged by the National Mental Health Programme (NMHP) [Figures 1 and 2 has explained].


Factors influencing access to psychiatric treatment in persons with schizophrenia: A qualitative study in a rural community.

Reddy SK, Thirthalli J, Channaveerachari NK, Reddy KN, Ramareddy RN, Rawat VS, Narayana M, Ramkrishna J, Gangadhar BN - Indian J Psychiatry (2014)

Complex interplay of reasons for Mrs. G to remain untreated
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927246&req=5

Figure 2: Complex interplay of reasons for Mrs. G to remain untreated
Mentions: Multiple factors preventing each patient's access to treatment should be considered while planning programs that attempt to bring all patients with psychoses under treatment. For instance, making treatment available locally may address the issue about distance and transport factors, but would do little to overcome the reasons posed by lack of awareness, family dynamics, family support, etc., This may result in many patients remaining untreated even if treatment is made available in primary health centers as is envisaged by the National Mental Health Programme (NMHP) [Figures 1 and 2 has explained].

Bottom Line: In low and middle-income countries, about 80% of those who need mental health services do not receive them.In addition to the well-known factors, many hitherto less-understood factors (e.g., families' conflicts, dynamics, resilience and acceptance, and community support, etc.) were identified which prevented patients and their families from seeking treatment.These findings have important policy implications.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.

ABSTRACT

Purpose: In low and middle-income countries, about 80% of those who need mental health services do not receive them. Reasons for this have not been systematically studied. In this qualitative study, we explored this issue in a rural community of South India among schizophrenia patients.

Materials and methods: Patients who had never sought psychiatric treatment despite long-standing psychotic illnesses were identified as part of a community intervention program. In-depth interviews were conducted with patients' caregivers to understand factors preventing them seeking psychiatric treatment. Interviews were audio-recorded and transcribed. Reasons cited by family members were listed and grouped into factors based on themes. Interview process was iteratively followed till no new factor emerged. Sixteen caregivers were thus interviewed.

Results: Content analysis brought out 75 reasons, which were further grouped under the following 15 factors [n (%)]: Lack of awareness about the illness: 15 (93.75%); lack of family support: Nine (56.25%); religious attributions: Nine (56.25%); financial constraints: Six (37.5%); family dynamics: Seven (43.75%); family's tolerance: Seven (43.75%); lack of insight: Five (31.25%); families resilience: Four (25.0%); community beliefs regarding mental illnesses: Four (25%), and others. In each patient, a complex interplay of several of these factors precluded the family from seeking psychiatric treatment.

Conclusions: In addition to the well-known factors, many hitherto less-understood factors (e.g., families' conflicts, dynamics, resilience and acceptance, and community support, etc.) were identified which prevented patients and their families from seeking treatment. These findings have important policy implications.

No MeSH data available.


Related in: MedlinePlus