Pathways to psychiatric care in Ibadan, Nigeria

Area of Science:

• Psychiatry
• Medical Anthropology
• Global Health

Background:

• Patient pathways to psychiatric care are influenced by available services and cultural beliefs about mental illness.
• Understanding these pathways can identify delays and suggest improvements in mental healthcare access.
• Traditional and religious healers play a significant role in the initial care-seeking behaviors of individuals with mental illness in many societies.

Purpose of the Study:

• To investigate the pathways to psychiatric care for patients in Nigeria.
• To identify the role of traditional and religious healers in the patient journey.
• To analyze factors contributing to delays in accessing tertiary psychiatric services.

Main Methods:

• A study of the pathways to care for 159 patients at a tertiary psychiatric service in Nigeria.
• Analysis of patient demographics, presenting complaints, and initial care providers.
• Comparison of care-seeking behaviors between patients consulting traditional healers versus orthodox medical practitioners.

Main Results:

• Traditional and religious healers are consulted by many patients and are the first point of contact for a significant proportion.
• Patients consulting traditional healers first experienced longer delays in reaching the tertiary psychiatric service.
• No significant differences were found in demographics, complaints, or proximity to service between patients consulting traditional healers first and those consulting orthodox practitioners first.

Conclusions:

• Traditional healers are a crucial first point of contact for many Nigerian patients with mental illness.
• The initial consultation with traditional healers can lead to significant delays in accessing specialized psychiatric care.
• Healthcare system integration efforts should focus on enhancing the referral capabilities of traditional healers to improve patient outcomes.