Barriers to Help Seeking Behavior in Patients of Psychosis-a Comparative Study between Hunan,China and Mauritius
|School||Central South University|
|Keywords||Duration of untreated psychosis (DUP) Help seekingbehavior Barriers Caretakers Patients|
Aims:This study aims to study four barriers that were identified from previous studies-sociodemographics, geographic barriers, economic barriers and stigma and discrimination, and compare them across two different and faraway countries (Hunan, China and Mauritius). It also aims to study different perceptions of treatment barriers between patients and their respective family members.Method:Questionnaire based interviews of300patients and their respective family members were done in Hunan and Mauritius from December2011to January2013.200patients and their respective family members were interviewed in Hunan, based on two questionnaires; one was addressed to the patient and the other to the family member, and the questions were similar in nature, though addressed to different people. The sample of400was interviewed at the Mental Health Institute (both wards and outpatient departments) of the Second Xiangya Hospital. Same was done to100patients and family members in Mauritius at the Brown Sequard Mental Health Care Centre.Results:A DUP of more than3months was associated with patients of female gender in the30-39years age group (p=0.013) and in divorced subjects (p=0.018) in Hunan province only. This was not mirrored in Mauritius. A long DUP did not have any statistical relationship with long distance travelled in any of the two places. A low monthly income was associated with a long DUP in Mauritius (p=0.018) but not in Hunan. Cheaper treatment options which included traditional Chinese Medicine and religious treatment were associated with a longer DUP in Hunan province only (p=0.087). Stigmatic factors associated with a long DUP included the fear of being avoided (p=0.076) and breakup of the couple (p=0.014) by Hunan patients. Fear of being disinherited was associated with a longer DUP in Mauritian patients (p=0.089) and Hunan family members (p=0.013).Conclusions:Results of this study are markedly different from previous studies in other countries and in the two countries in which the research was carried out, which reflects the impact of culture on treatment barriers. The treatment barriers which were identified in this study are older female and divorced patients, alternative methods of treatment and some aspects of stigma in Hunan. Treatment barriers to psychosis identified in Mauritius were a low monthly income and being disinherited on the grounds of mental illness. This shows that lack of family support plays a role in delaying help seeking for psychosis in both places.