A Qualitative Analysis of Patients’ Experiences during their Pathway to Psychiatric Care

Abstract

Introduction: The pathway to care in psychiatry consists of a detailed and systematic description of sources of care used by the patients before seeking help from mental health professionals (MHP).Understanding this will help us to recognize the potential sources of delay in presenting to mental health professionals (MHP) hence reasons for duration of untreated illness (DUI). This is of special interest in India because of the shortage ofMHPand the cultural diversity where many seek help from magico-religious healers (MRH). Traditional healing has a long and significant history in India. Objectives: To qualitatively evaluate the experiences of patients during various pathways taken by them through narrative analysis. Methods: This study was conducted at the psychiatric Department of PIMS. Those who had more than 2 encounters in the quantitative study were invited to participate. Interviews were conducted ensuring privacy, comfort and confidentiality. Themes were analysed using inductive coding method from the in-depth interviews. Results: Themes related to participant's understanding about the illness, first symptom that triggered initiation of treatment, nature of encounters, reasons attributed by patients and healers, and remedies done emerged. Themes related to their understanding and suggested remedies were so unique to the Indian culture. And some patients had experienced violent and cruel methods as remedies. They had also spent a lot of money on these remedies about which they regretted later. Conclusions: This study throws light in to the understanding of the pathways taken by psychiatric patients in South India and the need to promote awareness among general public including the magicoreligious healers.