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Referral Patterns, Pathways to Care, Symptom Profile, and Diagnoses of Children Attending a Child Psychiatry Unit in
Rashmi Vishwanath1, Jithin Thekkelkuthiyathottil Joseph2, Avinash G Kamath3
1Dept. of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Karnataka, India.
Insights
Childhood mental disorders in India show specific referral patterns. Most children seek initial care from general healthcare providers, with attention deficit hyperactivity disorder being a common diagnosis. Findings aid in planning child psychiatry services.
Area of Science:
- Child and Adolescent Psychiatry
- Mental Health Services Research
- Pediatric Psychology
Background:
- Childhood mental disorders represent a significant global health challenge, with India facing a persistent treatment gap.
- Existing child psychiatry services in India struggle to meet the demand, necessitating an investigation into care access and diagnostic trends.
- Understanding referral patterns and pathways to care is crucial for improving mental health outcomes in children.
Purpose of the Study:
- To investigate referral patterns and pathways to care for children attending a child psychiatry unit (CPU).
- To identify diagnostic trends among pediatric mental health patients in India.
- To analyze demographic factors influencing care-seeking behavior and diagnoses in child mental health.
Main Methods:
- A retrospective chart review of 1,046 children's files from 2017-2022 at Kasturba Medical College, Manipal CPU.
- Data extraction included demographics, referral reasons, care pathways, and final diagnoses.
- Statistical analysis examined associations between care pathways, diagnoses, and demographic variables.
Main Results:
- The study cohort comprised children with a mean age of 11.2 years, predominantly male (63.2%).
- Most children (97.5%) initially consulted healthcare providers, with significant proportions seeing mental health professionals (29.3%) or medical specialists (59.6%).
- Common diagnoses included attention deficit hyperactivity disorder (16.5%), intellectual disability (14.7%), and pervasive developmental disorder (12.6%), with significant associations found between care pathways, gender, referral reasons, and diagnoses.
Conclusions:
- The findings offer critical insights into the characteristics of children with mental health issues in India.
- The observed trend towards medical model care pathways is a positive development for service integration.
- Results can inform the development of gender- and culture-sensitive child mental health services, optimize resource allocation, and guide future research in the field.
Background:
Childhood mental disorders are a major global concern, particularly in India. Despite efforts to establish child psychiatry services, the treatment gap persists. This study investigates referral patterns, pathways to care, and diagnostic trends among children attending a child psychiatry unit (CPU).
Methods:
A retrospective chart review (2017-2022) was conducted at the CPU of Kasturba Medical College, Manipal. Two investigators analyzed 1,046 files, extracting data on demographics, pathways to care, reasons for referral, and diagnoses. Inter-rater reliability was confirmed, and associations between pathways to care, diagnosis, and demographics were examined.
Results:
This study included children with a mean age of 11.2 years, predominantly male (63.2%). Most children (97.5%) first sought care from a healthcare provider, with 29.3% consulting mental health professionals (MHPs) and 59.6% visiting medical specialists. Primary reasons for referral included behavioral disturbances, emotional disturbances, and academic decline. Common primary diagnoses were attention deficit hyperactivity disorder (16.5%), mental retardation (14.7%), and pervasive developmental disorder (12.6%). Significant associations were found between pathways to care and diagnosis (P = .001), as well as between gender and both referral reasons (P < .001) and diagnoses (P < .001).
Conclusions:
The study provides insights into the demographic and clinical characteristics of children with mental health problems in India. The medical model of care pathways is a positive shift, and these findings can guide gender- and culture-sensitive service planning, optimize resource allocation, and inform future research in child psychiatry.
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