When someone experiences an episode of psychosis, it could be a sign that he or she is at risk for developing a serious psychological issue, such as schizophrenia or borderline personality disorder. Sadly, many people, especially those from certain cultures, delay seeking treatment because of the stigma associated with mental illness. Research has shown that the longer an illness goes untreated, the worse the outcome. Therefore, it is crucial that treatment avenues be made available to people at the earliest stages of symptom onset. A mental health helpline, a telephonic hotline staffed with trained mental health professionals, is one such avenue of care. This type of program allows individuals to access help 24 hours a day, seven days a week, and ensures anonymity. Most helplines are free of cost, making them accessible to people of every socioeconomic status. They open the door to treatment and diagnosis.
To date, few studies have explored how helplines increase treatment enrollment for people with symptoms of psychosis. Many individuals attribute their first psychotic episode to other problems, such as life stressors, depression, anxiety, or substance use, not realizing that they may be at risk for clinical psychotic conditions such as schizophrenia. To determine how well helplines serve individuals at risk, Yves Bureau of the Silver Mind Hospital in India analyzed telephonic traffic from a community helpline in Mumbai over a five-year period. The data revealed that more than 15,000 people used the helpline during that period. Of those, 66% chose to use the services of a mental health professional, but only 33% made an appointment with a psychiatrist. Of those who called after their first psychotic episode, just over one-third saw a psychiatrist immediately, while more than one-third chose one year of therapy followed by a clinical assessment.
“It is clear that in the early phase of illness, patients and relatives prefer to see a mental health professional other than a psychiatrist,” Bureau said. People seeking help may be worried that they will receive a diagnosis of schizophrenia and consequently delay assessment. In fact, because many first-contact clients had symptoms of psychosis, depression, or anxiety rather than substance use or personality disorders, this suggests that clients in Mumbai tend to wait until they are in a mental health crisis before they reach out for help. Bureau also found that the first-time callers had a much shorter duration of symptoms than those with a history of psychotic issues. This finding underscores the importance of mental health helplines and demonstrates that this type of program could provide early care to individuals most at risk for psychological problems.
Bureau, Yves, et al. Reducing treatment delay for early intervention: Evaluation of a community based crisis helpline. Annals of General Psychiatry 11 (2012): 20. Health Reference Center Academic. Web. 28 Sep. 2012.
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