Help-seeking Pathways for In-patients with First-episode Psychosis in Hospital Kuala Lumpur

Introduction: Help-seeking pathway in psychiatry is the important link between the onset of a mental disorder and mental health service provision. Understanding of the help-seeking pathway can help us to device more effective strategies for early detection and treatment. Objectives: To determine the help-seeking pathways and treatment delaying factors of in-patients with first-episode psychosis in Hospital Kuala Lumpur (HKL). Methods: This is a hospital-based cross-sectional descriptive study of 50 in-patients with first-episode psychosis in HKL. Structured Clinical Interview for DSM-IV - Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Socio-demographic data, information on help-seeking pathways, and treatment delaying factors were determined through faceto-face interview and semi-structured questionnaires. Results: The number of non-psychiatric helpseeking contacts prior to first consultation with psychiatric service ranged from 0 to 10. The mean (±SD) number of contacts was 2.3 ( ±2.6), and median was 1 (IQR = 0 to 3). About a third of them (32%) had three or more non-psychiatric contacts. The most common point of first non-psychiatric contact was with traditional healer 24 (48%), followed by general practitioners 12 (24%), and only 14 (28%) of them sought help directly from psychiatric service. The most common reason reported for delay in seeking psychiatric treatment was, “not aware that changes were related to mental illness” (74%). Conclusions: History of contacts with traditional healers was common among in-patients with first episode psychosis in HKL. Treatment delay was mainly contributed by factors related to lack of awareness on psychosis. More strategic mental health education program is needed for early detection and treatment of psychosis.