Academic journal article Indian Journal of Psychiatry

Clinical Profile of Patients Seeking Services at Urban Community Psychiatric Services in Chandigarh

Academic journal article Indian Journal of Psychiatry

Clinical Profile of Patients Seeking Services at Urban Community Psychiatric Services in Chandigarh

Article excerpt

Byline: Suravi. Patra, Bir. Chavan, Nitin. Gupta, Ajeet. Sidana

Context: About two-third of patients with mental, neurological, and substance use disorder in India do not get adequate treatment due to insufficient clinical facilities. In a country with diverse population such as India, no single model can be effective and each region needs to develop local system of service delivery unique to population needs. Community outreach clinics (COCs) being run by the department of psychiatry provide mental health services in the primary health-care setting. The study reports on the pattern of service utilization across different COCs in Chandigarh. Aims: The aim of this study was to describe the sociodemographic and clinical profile of patients seeking mental health-care services from COCs and to compare this with patients seeking care at tertiary care center. Settings and Design: This was a cross-sectional case record review. Subjects and Methods: Community services are provided in the areas adjoining Chandigarh, through four COCs: Civil Dispensary, Dhanas; Khuda Ali Sher; Rural Health Training Center, Palsaura; and Police Dispensary Sector 26 by Department of Psychiatry, Government Medical College and Hospital, Chandigarh. The current study reports on sociodemographic and clinical profile of 728 patients seen in these clinics from July 2010 to June 2011. Statistical Analysis Used: Descriptive statistics were performed using SPSS version 16.0. Chi-square test was used to compare two groups, ANOVA for comparing more than two groups. Results: Out of the 728 patients, majority were males in productive age group with diagnosis of substance use disorder. Majority were reaching the clinics on their own and only a few were referred by various community referral agencies. Only twelve patients needed referral to the Department of Psychiatry in the above mentioned period. Conclusions: Patients of substance use disorder prefer to be seen in the outreach clinics and it is possible to manage them in these clinics with very little need to refer them to tertiary care hospitals.

Introduction

Mental, neurological, and substance use (MNS) disorders constitute 13% of global burden of disease.[sup][1] The burden caused by MNS disorders has increased by 41% from 1990 to 2010 due to population rise.[sup][2] Three quarters of this burden lie in low- and middle-income countries out of which, a similar proportion do not have access to services owing to poor resources.[sup][3] Globally, there has been a call for increasing access to mental health services.[sup][4] The focus is on developing models of services that are effective, efficient, sustainable, replicable in a similar set-up and are grounded on firm research base.[sup][5]

Community-based models are found to be effective and efficient in providing mental health care to the masses.[sup][6] Experts suggest a two-pronged approach in meeting the unmet needs of the community-strengthening of psychiatry units at district hospitals to work as focal centers for mental health services delivered through outpatient clinics and training of mental health personnel working at primary health care.[sup][7] Internationally, there are efforts at integrating mental health care into community-based primary level health services.[sup][8]

Mental health service providers are continuously striving to devise innovative ways to bridge the unmet needs.[sup][9] In the resource crunched low- and middle-income countries, many local models of care delivery have proven their efficacy and feasibility.[sup][10]

The District Mental Health Program, currently running in 123 of the 652 districts of India, is a component of the National Mental Health Program aimed at integrating mental health services into general health care. Shortage of qualified mental health professionals and low involvement of primary health-care professionals in mental health services delivery are adversely impacting service delivery. …

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