Pathways to psychiatric care in South-Verona, Italy

Abstract

SynopsisThis paper compares the pathway to psychiatric care of patients contacting the South-Verona Community Psychiatric Service (CPS) with the pathways described in other countries, using the method of the WHO cross-cultural study of pathways in psychiatric care. One hundred and sixteen South-Verona residents starting new episodes of care were traced and included in the study. The first port of call for 92% of patients was a doctor. More than one-third arrived at the CPS directly, not filtered by other carers. One-third went first to the GP and then straight to the CPS. Both the median total interval since onset of symptoms and the median interval between onset of the problem and first seeking care was 8 weeks. Patients presenting first at the two major ports of call tend to have a quite similar latency period before seeking care. Problems presented are represented mostly by depression and anxiety. The diagnosis of affective disorders occurred in more than half of the sample, followed by neurotic and somatoform disorders and schizophrenia and related disorders. The intervals after seeing the first carer are short and quite homogeneous among all patients. More than three-quarters of the patients said that they received some form of treatment for their presenting problems prior to arrival at the CPS, mostly psychopharmacotherapy with sedatives/hypnotics. These results are discussed in the light of those obtained in the WHO cross-cultural study.

Pathway to psychiatric care in Bali

“…Balestrieri et al . stated that the negative aspect associated with patients going directly to psychiatric service is ‘psychiatrization’ of ‘minor’ psychiatric problems, which could be managed in other less‐specialized facilities 20 . Also in Bali, if some patients can be effectively treated by traditional healers, it would be better, in terms of accessibility, availability, expense, and stigma, for patients and their families not to go to a mental hospital but to consult with traditional healers in their community.…”

Treatment delay and pathways to care in early psychosis

“…pathways into care), symptoms, daily functioning and demographics were obtained. Help seeking was assessed using a semi‐structured interview that combined information from two previously published schedules, a first‐episode‐specific instrument and a modified version of the World Health Organization Encounter Form . Referral to the program was defined as the final step in the pathway.…”

“…Help seeking was assessed using a semistructured interview that combined information from two previously published schedules, a first-episode-specific instrument 20 and a modified version of the World Health Organization Encounter Form. 21 Referral to the program was defined as the final step in the pathway. Onset of psychosis was assessed using an interview schedule adapted from the Symptom Onset in Schizophrenia Inventory 22 and the Interview for the Retrospective Assessment for Onset of Schizophrenia.…”

Pathways to care of first-admitted subjects with psychosis in South-Western France

“…The pathways to psychiatric care have been studied primarily for mental health disorders in general (Goldberg & Huxley, 1980 ;Rogler & Cortes, 1993;Balestrieri et al 1994;Kilic¸et al 1994). Goldberg & Huxley (1980) developed the concept of 'filter ' in pathways to psychiatric care, in order to identify the obstacles encountered by patients seeking help for mental health problems.…”