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The pathways to psychiatric care: a cross-cultural study

Published online by Cambridge University Press:  09 July 2009

R. Gater ,
De B. Almeida E. Sousa ,
G. Barrientos ,
J. Caraveo ,
C. R. Chandrashekar ,
M. Dhadphale ,
D. Goldberg ,
A. H. Al Kathiri ,
M. Mubbashar  and
K. Silhan
...Show all authors
R. Gater*
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
De B. Almeida E. Sousa
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
G. Barrientos
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
J. Caraveo
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
C. R. Chandrashekar
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
M. Dhadphale
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
D. Goldberg
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
A. H. Al Kathiri
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
M. Mubbashar
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
K. Silhan
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
D. Thong
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
F. Torres-Gonzales
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
N. Sartorius
Affiliation:
Mental Health Division, World Health Organization, Geneva and the Mental Illness Research Unit, University of Manchester
*
1 Address for correspondence: Dr R. Gater, University of Manchester, Department of Psychiatry, Withington Hospital, West Didsbury, Manchester M20 8LR.
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Synopsis

This paper describes the referral pathways taken by 1554 patients newly referred to the mental health services in 11 countries, and documents factors associated with delays in referral. The pathways in centres relatively well provided with psychiatric staff were dominated by general practitioners and to a lesser extent hospital doctors: the relatively less well resourced centres showed a variety of pathways with native healers often playing an important part. Delays were remarkably short in all centres regardless of psychiatric resources, but in some centres we found longer delays on pathways involving native healers. Somatic problems were a common presentation in all centres, and in some centres there was a tendency for patients presenting with somatic problems to have longer delays than those with symptoms of depression or anxiety. The implications of these findings are discussed in the context of an ongoing programme of WHO research activities aimed at improving the quality of mental illness care available in community settings.

Type
Original Articles
Information
Psychological Medicine , Volume 21 , Issue 3 , August 1991 , pp. 761 - 774
Copyright
Copyright © Cambridge University Press 1991

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References

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