Pathways to care for patients with a first episode of psychosis: a multicentric and multiethnic study

The aim of this study is to describe the care pathways for patients with a recent onset of psychosis and to determine whether these routes are significantly affected by ethnicity and causal beliefs about this disorder. A total of 252 patients with schizophrenia in outpatient treatment (116 Aymara and 136 Non-Aymara) with a mean age of 35.6 years (SD = 12.5) from public mental health centers in Arica, Chile (33.6 %), Tacna, Peru (33.6 %) and La Paz, Bolivia (32.8 %) and their primary caregivers participated. They were interviewed regarding their help-seeking contacts using a semi-structured questionnaire. Out of the total patients, 64.7 % initially contacted a general practitioner for help, while only 14 % went to see a psychologist and 12 % sought a Yatiri (healers). The main factors associated with avoidance of a different route were the presence of a supportive family member or friend and the presence of a general practitioner. It is concluded that the main route of access to psychiatric services for patients with a recent onset of psychosis among Andean ethnic minorities is through a general practitioner, while a small portion of this population relies on community healers.