The sociocultural factors and patterns of help-seeking among patients with mental illness in the sub-Himalayan region

Abstract

Context: Selection of first help in psychiatric illnesses depends on various sociodemographic and environmental factors. In integrated societies like India careers also contribute in deciding help-seeking behavior of psychiatric patients. In this study, we explored these factors and the role of education of decision maker, i.e., person who is final authority in deciding the course of management. Aims: This study aims to study sociocultural factors and patterns of help-seeking behavior of psychiatric patients in rural sub-Himalayan region. Settings and Design: A cross-sectional study conducted in a tertiary care teaching hospital. Subjects and Methods: Factors affecting help-seeking behavior such as age, sex, education, occupation, income, accessibility to psychiatric treatment, expenses on faith healers and general practitioners, and education of “decision maker were assessed. Statistical Analysis Used: Data were analyzed with GraphPad InStat, using appropriate statistical tests. Results: In this study of 250 patients, psychiatrists were chosen as first help by 98 (39%), faith healers by 84 (34%), and general medical practitioners (GMPs) by 68 (27%) patients. Mean “years of education” of patients in psychiatrist group, faith healer group, and GMP group were 9.98, 8.81, and 7.99, respectively ( P = 0.08). Mean “years of education” of decision makers for these groups were 11.64, 8.36, and 10.93, respectively ( P < 0.001). Time required in reaching psychiatric facility form the residence of patient was maximum in those who consulted faith healers first compared to those who consulted psychiatrist ( P < 0.001) or GMP ( P < 0.01). Expenses on faith healers were significantly high compared to GMPs ( P < 0.001). Conclusions: Psychiatrists, faith healers, and GMPs were equally chosen as first help for psychiatric illness. Education of decision maker and accessibility affect help-seeking behavior significantly. Faith healers were more expensive than GMPs.

Role of Faith healers: A barrier or a support system to medical care- a cross sectional studyRole of faith healers: A barrier or a support system to medical care, a cross sectional study

“…where they found that easy accessibility followed by trust in faith healers are good reasons to access the faith healers. [ 25 ] In a study by Pal SK et al . regarding various types of treatment strategies adopted by families of patients with epilepsy in north western India found that families did adopt some culturally prevalent methods to control involuntary movements during seizures.…”

Help-seeking for mental health concerns: review of Indian research and emergent insights

“…On the other hand, support from family and well-wishers proved beneficial in sustaining engagement with professional help-seeking [53]. Education of the decision-maker significantly influenced help-seeking behaviors [54]. Patients and caregivers having higher awareness about mental illness sought help from mental health professionals sooner, whereas, those with lower awareness contacted faith healers first [49].…”

Delay and treatment factors of psychiatric treatment among patients seeking faith healers

“…This finding resembles the observation in an Indian study which found no significant association of ICD-10 diagnostic groups with seeking care from faith healer or psychiatrist. 14 The most common reasons for visiting faith healers in the present study were cultural perception of mental disorders and belief in miraculous cure. This is almost similar to the observations made by earlier studies which have talked about cultural/religious beliefs and magical cure beliefs as reasons for faith healer visits.…”

“…An earlier Indian study had noted no significant association of marital status with faith healer visit. 14 An earlier study from Kerala also showed a similar distribution of religions and showed no preponderance among any religion to visit faith healers. 11 There was no association of psychiatric diagnosis with seeking faith healers.…”

“…This finding is also echoed across different studies. 1,10,14 Following psychiatric treatment, 57% were able to accept that mental illnesses are medical/brain disorders. The pattern was also shown by a study from rural and urban India, which showed that 59.1% and 65.5% respectively were able to accept it as an imbalance of brain/ neurotransmitters.…”