Pathways to psychiatric care in Ethiopia
Pathways to psychiatric care in Ethiopia
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DOI：
10.1017/s0033291708003929
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发表时间：
2009-03-01
影响因子：
6.9
通讯作者：
Baheretebeb, Y.
中科院分区：
文献类型：
--
作者：
Bekele, Y. Y.;Flisher, A. J.;Baheretebeb, Y.
背景了解精神病治疗的途径和认识的延迟点是至关重要的干预措施，旨在改善获得精神卫生保健服务的发展。在2003年的2个月内，共有1044名患者在开始新的事件的照顾在阿曼努尔专门精神病院在埃塞俄比亚的阿迪斯进行了采访，使用的遭遇形式，是由世界卫生组织（WHO）开发的研究途径，以精神病护理。41%的病人直接联系过精神病院。其余的病人在到达精神病医院之前向多达四个不同的照顾者寻求照顾。在精神病医院没有接受初步服务的情况下，30.9%的病人寻求牧师/圣水/教堂的护理。发病和到达精神病医院之间的中位延迟时间为38周。到达精神病院前最长的延迟与没有接受过正规教育、失业、癫痫诊断和身体状况有关。实施一个强有力的转诊制度，与传统和现代保健提供者建立强有力的工作关系，并设计一个针对特定人群的服务提供模式，如未受教育、失业和（或）患有癫痫和身体疾病的人群，这应该是改善埃塞俄比亚精神卫生服务提供和缩短患者接受精神病治疗的不当延误的最重要战略。
Background. Understanding the pathways to psychiatric care and recognition of delay points are crucial for the development of interventions that aim to improve access to mental health-care services.Method. Over a 2-month period in 2003, a total of 1044 patients at the commencement of new episodes of care at Amanuel Specialized Mental Hospital in Addis Ababa, Ethiopia were interviewed using the encounter form that was developed by the World Health Organization (WHO) for the study of pathways to psychiatric care.Results. The mental hospital was contacted directly by 41% of patients. The remaining patients sought care from up to four different caregivers before arriving at the psychiatric hospital. Where the initial service was not received at the psychiatric hospital, 30.9% of patients sought care from priests/holy water/church. The median delay between onset of illness and arrival at the psychiatric hospital was 38 weeks. The longest delays before arriving at the mental hospital were associated with having no formal education, joblessness, and diagnoses of epilepsy and physical conditions.Conclusions. Implementing a robust referral system and establishing a strong working relationship with both traditional and modern health-care providers, as well as designing a service delivery model that targets particular segments of the population, such as those who are uneducated, jobless and/or suffer from epilepsy and somatic conditions, should be the most important strategies towards improving mental health service delivery and shortening of undue delay for patients receiving psychiatric care in Ethiopia.