Service utilization in a tertiary psychiatric care setting in South India

To carry out an audit reviewing the utilization of psychiatric services and types of disorders presenting to a tertiary care psychiatry hospital in a developing Asian country.

Consecutive adult patients who came for detailed consultation in 1 year were included in this study. A senior consultant psychiatrist reconfirmed the diagnosis in each patient who underwent detailed psychiatric evaluation. Psychiatric evaluation consists of clinical history from the patients and the relatives and a mental state examination. Data was obtained from the detailed work up evaluation psychiatry records of these patients.

Mood disorder was the most common diagnosis followed by substance use disorders and psychotic disorders (ICD 10). There is a substantial delay of more than 2-5 years for seeking treatment in most disorders including schizophrenia. More than 80% of the population directly seeks treatment at this tertiary hospital. Sixty-four percent of the patients came for at least one follow up.

The result suggests the urgent need for strengthening community care in India and similar low and middle-income countries for early and optimal treatment.