Pathways to mental health care in Bangladesh, India, Japan, Mongolia, and Nepal

Abstract

Introduction: As mental health systems are still developing in many Asian countries, knowledge of the pathways to mental health care (MHC) in this region would be very important.

Aims: To clarify the pathways to MHC in 5 Asian countries.

Method: A total of 50 new subjects attending each institution were interviewed. Pathway diagrams, the patterns and duration of care seeking, and the previous treatment were compared.

Results: Four major pathways were direct access, referrals from private practitioners, referrals from general hospitals, and referrals from native or religious healers. General practitioners did not play a pivotal role in any of the areas, whereas native or religious healers had an important place in all areas except for Yokohama, Japan. Family members had a significant impact on the decision to seek MHC.

Conclusions: Studies of pathways to MHC in Asian countries are feasible and can provide data of interest in the organization of care.

Keywords: Bangladesh; India; Japan; Mongolia; Nepal; help seeking; pathway; psychiatry.