Referral Network Pathways of Care for Psychiatric Disorders in Kashmir - A Study from India

Objective: Access to psychiatry services in Kashmir is challenging because of active enduring conflict, insecurity and a fundamental role played by the traditional health workers. We aimed to assess the main pathways to mental health services in Kashmir, India. Methods: This cross-sectional hospital-based study was performed from March 2012 to June 2017 in the outpatient psychiatry department at a psychiatric disease hospital in Kashmir. A convenience sampling method was used to select newly referred patients to the services. A survey was developed to collect information on demographic data and the main pathways for patients when seeking care for mental disorders. Results: A total of 518 patients were interviewed. About half of the respondents (48.8 %) attended clinical consultation from a general pathway like a physician or a neurologist, while 31.8% were visiting a psychiatrist for a significant psychiatric disorder. For some patients (17.8%), their initial pathway to mental health services is traditional healers. Conclusion: The current study revealed different pathways to seeking psychiatric care in Kashmir India. Further studies are needed to address the treatment gap and ways to improve access to mental health services for the Kashmir population.