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Pathways to care among psychiatric outpatients in a tertiary mental health institution in Singapore

Author

Listed:
  • Anitha Jeyagurunathan
  • Edimansyah Abdin
  • Saleha Shafie
  • Peizhi Wang
  • Sherilyn Chang
  • Hui Lin Ong
  • Restria Fauziana Abdul Rahman
  • Vathsala Sagayadevan
  • Ellaisha Samari
  • Yi Chian Chua
  • Janhavi Ajit Vaingankar
  • Swapna Kamal Verma
  • Ker-Chiah Wei
  • Siow Ann Chong
  • Mythily Subramaniam

Abstract

Background: Pathways to care studies in Singapore are of high interest given the cultural diversity and various sources of help available for those with mental illnesses, ranging from the more traditional to tertiary-level mental health care services. Aim: The current study aimed to explore the associations of patients’ socio-demographic characteristics with pathways to first contact and duration of untreated mental illness. Method: A total of 402 participants were recruited through convenience sampling. A pathway to care form was used to gather systematic information about the sources of care utilized by participants before approaching a mental health professional. Data were analysed using multinomial logistic regression and multiple linear regression models to assess the associations. Results: Majority of participants reported primary care (36.0%) as their first point of contact, followed by non-formal sources of help (33.8%), specialist care (21.8%), police/court (4.0%), websites/media (3.3%) and religious/traditional treatment (1.3%). Those belonging to Malay and Indian ethnicity (vs Chinese) were more likely to make first contact with non-formal sources of help than primary care. Those who received a diagnosis of any mood or anxiety disorder (vs schizophrenia and related psychoses) were less likely to make first contact with specialist care or non-formal sources of help than primary care. Those who were separated/divorced/widowed were significantly associated with higher duration of untreated illness compared to those who were single. Participants whose family/relative initiated the first contact were significantly associated with a shorter duration of untreated illness compared to those who initiated first contact on their own. Conclusion: Findings suggest the determinants of the pathways to first contact and duration of untreated illness included diagnosis, ethnicity, marital status and family initiating the first contact. The pathways adopted by these participants need to be kept in mind for planning mental health programmes.

Suggested Citation

  • Anitha Jeyagurunathan & Edimansyah Abdin & Saleha Shafie & Peizhi Wang & Sherilyn Chang & Hui Lin Ong & Restria Fauziana Abdul Rahman & Vathsala Sagayadevan & Ellaisha Samari & Yi Chian Chua & Janhavi, 2018. "Pathways to care among psychiatric outpatients in a tertiary mental health institution in Singapore," International Journal of Social Psychiatry, , vol. 64(6), pages 554-562, September.
    • Handle: RePEc:sae:socpsy:v:64:y:2018:i:6:p:554-562
    DOI: 10.1177/0020764018784632
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    References listed on IDEAS

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    1. S.M. Razali & M.A.M. Najib, 2000. "Help-Seeking Pathways Among Malay Psychiatric Patients," International Journal of Social Psychiatry, , vol. 46(4), pages 281-289, December.
    2. Morgan, Craig & Mallett, Rosemarie & Hutchinson, Gerard & Leff, Julian, 2004. "Negative pathways to psychiatric care and ethnicity: the bridge between social science and psychiatry," Social Science & Medicine, Elsevier, vol. 58(4), pages 739-752, February.
    3. Chow, J.C.-C. & Jaffee, K. & Snowden, L., 2003. "Racial/Ethnic Disparities in the Use of Mental Health Services in Poverty Areas," American Journal of Public Health, American Public Health Association, vol. 93(5), pages 792-797.
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