ArticleInternational journal of mental health systems2021
Pathways to mental health care in Nepal: a 14-center nationwide study.
Article in International journal of mental health systems, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Depression and quality of life (QoL) among older adults in Sudurpashchim Province, Nepal: findings from a cross-sectional community survey.BMC geriatrics · 2026Article
- Article
- Beyond health economics: economic growth, artificial intelligence, and environmental externalities in shaping life expectancy.Frontiers in public health · 2026Article
- Facilitators in treatment pathways for depression or anxiety among adults in Nepal: a qualitative study.BMC public health · 2025Article
- Early intervention in psychosis programs in Africa, Asia and Latin America; challenges and recommendations.Global mental health (Cambridge, England) · 2025Review
- Mental health service readiness in Nepal: Insights from the 2021 Nepal Health Facility Survey.PLOS mental health · 2025Article
- Article
- Change in attitude and help-seeking pattern of caregivers and patients with mental disorders in the community - Recent findings from India.Journal of family medicine and primary care · 2022Article
- Burden of intimate partner violence, mental health issues, and help-seeking behaviors among women in Nepal.Women's health (London, England)Article
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18 authors at 9 institutions in 4 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPathways to care studies are feasible and tested means of finding the actual routes taken by patients before reaching proper care. In view of the predominance of nonprofessional service providers and the lack of previous large studies on pathways in Nepal, this multicenter study is needed. The aim of the study was to trace the various pathways and carers involved in mental health care; assess clinical variables such as the duration of untreated illness, clinical presentation and treatment; and compare geographically and culturally diverse landscapes.
methodsThis was a cross-sectional, convenience sampling study performed at 14 centers where new cases were being taken. The World Health Organization Study of the Pathways-to-Care Schedule was applied. The Nepali version of the encounter form was used. The data were collected between 17 September and 16 October 2020 and were analyzed using the Statistical Package for the Social Sciences (SPSS). Additionally, perspectives from local investigators were collected and discussed.
resultsMost of the first carers were native/religious faith healers (28.2%), followed by psychiatrists (26%). The median duration for the first psychiatric consultation was 3 weeks. The duration of untreated illness was 30.72 ± 80.34 (median: 4) weeks, and the time taken for this journey was 94.99 ± 274.58 (median: 30) min. The longest delay from the onset of illness to psychiatric care was for epilepsy {90.0 ± 199.0 (median: 25.5)} weeks, followed by neurotic illness {22.89 ± 73.45 (median: 2)} and psychotic illness {10.54 ± 18.28 (median: 2)} weeks. Overall, most patients with severe mental illnesses (SMIs) had their first contact with faithhealers (49%), then met with medical doctors (13%) or psychiatrists (28%). Marked differences in clinical presentation surfaced when hilly centers were compared with the Terai belt.
conclusionsFaith healers, general practitioners and hospital doctors are major carers, and the means of educating them for proper referral can be considered. The investigators see several hindrances and opportunities in the studied pathways. The employment of more mental health professionals and better mental health advocacy, public awareness programs and school education are suggested strategies to improve proper mental health care.
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