Title : Factors associated with Delayed Treatment Seeking among Mentally ill patients, in a Tertiary Care Center, Chennai, India, January 2022 to March 2022
Abstract:
Introduction
The International Early Psychosis Association insists on early treatment for mental illness to achieve a better outcome. Institute of Mental Health (IMH), Chennai, Tamil Nadu, India, offers tertiary care for mentally ill patients. Identifying the reasons for delayed treatment seeking by mentally ill patients may help for early initiation of treatment. We conducted a study to understand factors associated with delayed treatment seeking among the outpatients in IMH.
Methods
We conducted a cross-sectional analytical study from January to March 2022. We defined Delayed treatment-seeking as the time delay between the onset of psychotic symptoms and initiation of psychiatric treatment more than 6 months. We needed 808 samples. We did two-stage cluster sampling, our clusters being day clusters. We selected 25 patients per cluster. We collected data on sociodemographic characteristics and health-seeking behavior using a semi-structured questionnaire. We calculated adjusted odds ratio(AOR) and 95% confidence interval (95% CI) using multivariate logistic regression analysis.
Results
Among 808 participants, 68%(n=547) were males and 32%(n=261) were females. The mean age of the females and males was 38 years (Range:9-86 years) and 34 years (Range:6-90 years) respectively. Median income was Rs.8000. Most patients (70%) sought treatment within 6 months after the onset of symptoms(n=564). Being male gender{AOR=0.9,(95% CI=0.6–1.36)}, not having degree{AOR=1.3,(0.8–1.9)}, unskilled job{AOR=0.9,(95% CI = 0.5–1.5)}, marital status{AOR=1.1,95% CI= 0.8-1.6)}, history of family members with mental illness{AOR=0.8,(95% CI= 0.6–1.2)} or proximity of the residence to the IMH{AOR=1.1,(95% CI=0.7–1.6) were not associated with delayed treatment-seeking. Having seizure disorder {AOR=0.5, (95%CI=0.2-0.9)}and substance abuse {AOR=0.5, (95% CI=0.3–0.7) were negatively associated the outcome. Insomnia was positively associated with the delayed treatment seeking{AOR=2.3, (95% CI=1.4-3.8)}
Conclusion
Patients with seizure disorder and substance abuse sought treatment earlier. Patients with complaints of insomnia did not seek early treatment. We recommend the sensitization of the community regarding symptoms of mental illness to improve health-seeking behavior.
