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

Reddy, Shanivaram; Thirthalli, Jagadisha; Channaveerachari, Naveen Kumar; Reddy, Krishna; Ramareddy, Renukadevi Neralur; Rawat, Vikram Singh; Manjunatha, Narayana; Ramkrishna, Jayashree; Gangadhar, Bangalore N.

doi:10.4103/0019-5545.124714

Cited by 38 publications

(23 citation statements)

References 10 publications

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“…This does not only influence the choice of initial help sought but the stigma that follows might cause families to conceal the matter and delay help-seeking. Previous studies done in other countries have consistent results with this study (21,(42)(43)(44). Hence, addressing these cultural issues while developing intervention for promoting professional helpseeking behavior is important.…”

Section: Discussionsupporting

confidence: 89%

“…Many caregivers normalized such subtle changes which eventually delayed professional helpseeking. These findings are not surprising and have been described in other studies (15,16,21). In a qualitative study looking at how people identify and respond to emerging psychosis, Judge et al (16) found themes like normalization, giving explanation, withdrawal, avoiding help and coming to terms with psychosis which posed as barriers to help-seeking (16).…”

Section: Discussionsupporting

confidence: 58%

“…Research findings from the western countries may not be applicable to the lower-resourced and culturally diverse Asian countries. Several studies done in India, both quantitative and qualitative, have investigated factors affecting help-seeking behavior in schizophrenia (20)(21)(22). These studies indicated the presence of unique cultural factors as determinants of help-seeking (21) which may be different in Malaysia with its unique multi-racial population.…”

Section: Introductionmentioning

confidence: 99%

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Factors Influencing Professional Help-Seeking Behavior During First Episode Psychosis in Schizophrenia: An Exploratory Study on Caregivers’ Perspective

et al. 2020

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Schizophrenia is a severe mental illness that leads to significant productivity loss and is listed in the top 15 global burdens of disease. One important contributor to the high disease burden is duration of untreated psychosis (DUP) which can be shortened with promotion of professional help-seeking behavior. This study explored caregivers' perspective on factors influencing professional help-seeking behavior during first episode psychosis (FEP) in schizophrenia in Malaysia. The results of this study would inform the development of intervention strategies targeted at promoting professional helpseeking behavior in caregivers of individuals experiencing first episode psychosis (FEP). This is a thematic exploratory study which employed purposive sampling using focus group discussion (FGD). These interviews were audio recorded and transcribed verbatim. Basic thematic approach was used in analyzing the transcribed interviews. Two main themes identified were adequacy of knowledge and stigma. These two factors were found to co-influence each other. Stigma undermined the impact of knowledge on professional help-seeking; likewise, the reverse was also observed. Intervention strategies for promoting help-seeking behavior during FEP should simultaneously focus on improving knowledge about schizophrenia and reducing the stigma attached to it.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

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Factors Influencing Professional Help-Seeking Behavior During First Episode Psychosis in Schizophrenia: An Exploratory Study on Caregivers’ Perspective

et al. 2020

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“…Hence they tend to ignore the patient’s symptoms and treatment a practice which results into relapse [20]. …”

Section: Discussionmentioning

confidence: 99%

Risk and protective factors for relapse among Individuals with Schizophrenia: A Qualitative Study in Dar es Salaam, Tanzania

2014

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BackgroundRelapse in people with schizophrenia is a major challenge for mental health service providers in Tanzania and other countries. Approximately 10% of people with schizophrenia are re-admitted due to relapse at Muhimbili National Hospital (MNH) Psychiatric Unit each month. Relapse brings about negative effects and it results in a huge burden to patients, their families, the mental health sector and the country’s economy. So far no study has been done to address relapse in Tanzania. The purpose of the study was to explore perspectives on risk and protective factors influencing relapse of people with schizophrenia and their caregivers attending Muhimbili National Hospital Psychiatric Out-patient Department, Dar es Salaam, Tanzania.MethodsA qualitative study was conducted, involving in-depth interviews of seven people with schizophrenia who are out-patients and their seven family caregivers at MNH. Purposive sampling procedure was used to select participants for the study. Audio recorded in-depth interviews in Swahili language were conducted with all study participants. The recorded information was transcribed and analyzed using NVivo 9 computer assisted qualitative data analysis software.ResultsPersonal risk and protective factors for relapse, environmental risk and protective factors for relapse and suggestions to reduce relapse were the main themes that emerged from this study. People with schizophrenia and their caregivers (all of whom were relatives) perceived non adherence to antipsychotic medication as a leading risk factor of relapse; other risks included poor family support, stressful life events and substance use. Family support, adherence to antipsychotic medication, employment and religion were viewed as protective factors. Participants suggested strengthening mental health psycho-education sessions and community home visits conducted by mental health nurses to help reduce relapse. Other suggestions included strengthening the nurse-patient therapeutic relationship in provision of mental health care.ConclusionsThis study calls for improvement in mental health care service delivery to individuals with schizophrenia. Establishing a curricular in mental health nursing that aims to produce competent mental health nurse force would improve nursing practice in mental health care service delivery.

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“…Spirituality can potentially help patients in the process of illness recovery, by facilitating their autonomy and assisting them to live and grow beyond the limitations imposed by their illness . Faith, culture, spirituality, family, and community can all play a role in influencing access to, and provision of, psychiatric treatment of people with SMI (Reddy et al, 2014).…”

Section: Theme: Religion Spirituality Culture and Traditional Pramentioning

confidence: 99%

A structured review of psychiatric rehabilitation for individuals living with severe mental illness within three regions of the Asia‐Pacific: Implications for practice and policy

Hill

Killaspy

Padmavati

et al. 2019

Asia-Pacific Psychiatry

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Introduction Psychiatric rehabilitation can provide and support recovery‐oriented care by assisting individuals living with severe mental illness to lead full lives. Despite a well‐established evidence‐base, implementation and access to these interventions in clinical practice for people with severe mental illness in the Asia‐Pacific region is low. We therefore aimed to evaluate prominent themes impacting on clinical practice, policy, and the implementation of psychiatric rehabilitation across the Asia‐Pacific region. Methods A comprehensive review of relevant literature on psychiatric rehabilitation of three regions within the Asia‐Pacific was conducted using a structured search of PubMed and other databases. Eligible articles were selected which focussed on how psychiatric rehabilitation is defined and implemented across the Asia‐Pacific region, as well as the associated successes and challenges. Common themes were generated. Results Six themes emerged: the impact of policy, legislation, and human rights; access difficulties; the important role of family; the significance of culture, religion, and spiritual beliefs; the widespread impact of stigma; and the indigenous models of excellence being developed. Discussion Consideration of the six themes and their implications should help raise awareness of the issues involved in the provision of psychiatric rehabilitation in the Asia‐Pacific region and may improve outcomes for people living with severe mental illness. Suggested strategies include: developing a shared understanding of psychiatric rehabilitation; establishing quality legislation that's well implemented; adapting evidence‐based models to develop culturally appropriate services; implementing stigma reduction and empowerment‐based interventions; and, ensuring coordinated action among all stakeholders, combined with effective leadership.

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

Cited by 38 publications

References 10 publications

Factors Influencing Professional Help-Seeking Behavior During First Episode Psychosis in Schizophrenia: An Exploratory Study on Caregivers’ Perspective

Factors Influencing Professional Help-Seeking Behavior During First Episode Psychosis in Schizophrenia: An Exploratory Study on Caregivers’ Perspective

Risk and protective factors for relapse among Individuals with Schizophrenia: A Qualitative Study in Dar es Salaam, Tanzania

A structured review of psychiatric rehabilitation for individuals living with severe mental illness within three regions of the Asia‐Pacific: Implications for practice and policy

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