ABSTRACT
BACKGROUND: Pathways to care studies in Singapore are of high interest given the cultural diversity and various sources of help available for those with mental illnesses, ranging from the more traditional to tertiary-level mental health care services. AIM: The current study aimed to explore the associations of patients' socio-demographic characteristics with pathways to first contact and duration of untreated mental illness. METHOD: A total of 402 participants were recruited through convenience sampling. A pathway to care form was used to gather systematic information about the sources of care utilized by participants before approaching a mental health professional. Data were analysed using multinomial logistic regression and multiple linear regression models to assess the associations. RESULTS: Majority of participants reported primary care (36.0%) as their first point of contact, followed by non-formal sources of help (33.8%), specialist care (21.8%), police/court (4.0%), websites/media (3.3%) and religious/traditional treatment (1.3%). Those belonging to Malay and Indian ethnicity (vs Chinese) were more likely to make first contact with non-formal sources of help than primary care. Those who received a diagnosis of any mood or anxiety disorder (vs schizophrenia and related psychoses) were less likely to make first contact with specialist care or non-formal sources of help than primary care. Those who were separated/divorced/widowed were significantly associated with higher duration of untreated illness compared to those who were single. Participants whose family/relative initiated the first contact were significantly associated with a shorter duration of untreated illness compared to those who initiated first contact on their own. CONCLUSION: Findings suggest the determinants of the pathways to first contact and duration of untreated illness included diagnosis, ethnicity, marital status and family initiating the first contact. The pathways adopted by these participants need to be kept in mind for planning mental health programmes.
Subject(s)
Mental Disorders , Mental Health Services/organization & administration , Outpatients , Patient Acceptance of Health Care/psychology , Adult , Cultural Diversity , Ethnicity , Female , Humans , Male , Mental Disorders/ethnology , Mental Disorders/psychology , Mental Disorders/therapy , Mental Health/ethnology , Mental Health/statistics & numerical data , Middle Aged , Needs Assessment , Outpatients/psychology , Outpatients/statistics & numerical data , Singapore/epidemiology , Socioeconomic Factors , Tertiary Healthcare/methods , Time-to-TreatmentABSTRACT
Affiliated stigma often refers to internalized stigma among family members of stigmatized individuals. This study aimed to investigate the relationship between affiliate stigma and quality of life (QOL) among primary caregivers of individuals with mental illness undergoing treatment at the Institute of Mental Health, Singapore. Three hundred and fifty caregivers were recruited for the study. The World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and Family Stigma Scale (FSS) were administered to the primary caregivers of patients with mental illness. Multiple linear regression analyses were conducted to investigate the association of affiliate stigma with QOL. A high proportion of caregivers of individuals with mental illness experience affiliate stigma in Singapore. All four QOL domains were significantly associated with affiliate stigma. These findings entail that it is imperative to improve public's perception of those with mental illness to reduce stigmatization and thus improve caregiver's QOL.
