Barriers, Cultural Variance and Pathways to Psychiatric Care: A Systemic Review

ABSTRACT

Background: Psychiatric illness is mostly chronic in nature and due to delay in treatment process the level of functioning is highly impaired along with it have a direct impact on individual quality of life. According to the National Report of NMHS reveals that nearly 83% people of India are need of active interventions for one or more mental health issues. Most of the identified had not sought for treatment or not able to access appropriate care despite seeking. The treatment gaps are huge in both rural and urban settings with direct or indirect influence of multiple factors. Materials and Methods: Systematically review of the literature was carried out to find out the barriers and cultural differences in pathways to psychiatric care among the patients with first episode psychosis. Studies were identified through searches of various electronic database (MEDLINE, PsycINFO, SCIENCEDIRECT, PubMED, Health STAR and CINAHIL) supplemented by backward and forward mapping and hand searching and citation tracing was carried out. We included studies on the pathways to psychiatric care of individuals aged 18-60years, both genders, written in English language and were published between 2010 to 2020.Two reviewers independently screened articles and extracted data. Results and Conclusion: The most common type of barriers mostly identified in the literature is Mental Health literacy and cost of the treatment followed by Structural barriers and negative experiences with the professionals played a key role in not approaching MHS. The most common reasons for drop-out from professional services included perceived ineffectiveness of treatment and negative experiences with treatment providers.