1496 – Pathways To Care In Psychiatry, The Example Of The Carpi’s Mental Health Service

Abstract

Introduction

Studying the pathways followed by psychiatric patients is important to plan both mental health services organization and training programmes for doctors and psychiatrists.

Objective

Detecting the main pathways-to-care followed by patients.

Aim

Finding the reasons why patients look for psychiatric help and the main responses given to patients’ problems by psychiatric services. Evaluating the delays occurring along the pathways.

Methods

The study has been done on 420 Italian patients. In one month, patients with a new episode of disease have been included. Each of them has been administered a questionnaire collecting socio-demographical, medical infos and data concerning health workers, timing and delays along the pathways. Diagnosis done using ICD-10 and an Intervention Detection Schedule filled for each patient.

Results

The Carpi’s sample consists of 43 patients. The 58% has seen the General Practitioner (GP) in the first place, the 19% the hospital doctor (HD), the 16% the psychiatric worker. Nation-widely, most patients have firstly referred to the psychiatrist (34%). In Carpi, the 44% has received a diagnosis of “Neurotic, stress-related and somatoform disorders”. The 93% has been treated with psychotropic medications. The longest pathway has occurred for behavioural syndromes associated with physiological disturbances and physical factors, the shortest for affective disorders.

Conclusions

GP, HD and direct access are the 3 main pathways followed by patients. The importance of the GP is confirmed, so as the necessity for training of sanitary workers within the psychiatric field. A greater cooperation between general practice and mental health services should be pursued