There is increasing evidence that delay in the commencement of treatment, following the onset of schizophrenia, may be related to the pathways patients navigate before accessing mental health care. Therefore, insight into the pattern and correlates of pathways to mental care of patients with schizophrenia may inform interventions that could fast track their contact with mental health professionals and reduce the duration of untreated psychosis. This study assessed the pathways to mental health care among patients with schizophrenia ( ), at their first contact with mental health services at the Federal Neuro-Psychiatric Hospital Yaba Lagos, Nigeria. Traditional and religious healers were the first contact for the majority (69%) of the patients. Service users who first contacted nonorthodox healers made a greater number of contacts in the course of seeking help, eventuating in a longer duration of untreated psychosis ( ). However, the delay between the onset of psychosis and contact with the first point of care was shorter in patients who patronized nonorthodox practitioners. The findings suggest that collaboration between orthodox and nonorthodox health services could facilitate the contact of patients with schizophrenia with appropriate treatment, thereby reducing the duration of untreated psychosis. The need for public mental health education is also indicated. 1. Introduction Schizophrenia is a severe, chronic, disabling mental disorder, with a lifetime morbid risk of about 1%, and a leading contributor to the global burden of diseases . Despite the availability of effective therapy, there is a huge treatment gap for schizophrenia, with more than 40 million affected people in need of treatment in low and middle income countries [2–4]. Systematic reviews and meta-analytic studies have shown that delay in the commencement of appropriate treatment following the onset of psychosis is associated with more severe symptom profile, worse psychosocial functioning, poorer quality of life, and poorer treatment outcomes in patients with schizophrenia [5, 6]. Efforts at reducing the lag in the initiation of treatment for first episode schizophrenia has led to an increasing research interest in the pathways through which people with the disorders access care, with the view of identifying points of delay and, consequently, potential loci of interventions that could minimize the delay. Pathways to care refer to the sequence of contacts an ailing person makes with services provided by individuals or organisations, prompted by the effort of the distressed persons
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