Alcohol Dependence Care Pathway for Psychiatric Settings: A Cross-sectional Study from an Urban Psychiatric Center

Abstract

Background: Alcohol use remains an important contributor to morbidity and mortality. There is a long-time gap between the onset of alcohol use and first contact for care. Poor referral systems and reduced awareness contribute to such delays. Yet few studies analyzed pathways to care exclusively in alcohol-dependent patients. Aims: The aim of this study was to understand the pathways traversed by alcohol-dependent patients before their access to psychiatric services and their association with sociodemographic and clinical characteristics. Methods: A cross-sectional study design was employed. All alcohol-dependent patients attending psychiatric outpatient department setting were recruited. Questionnaires including sociodemographic details, the Short Alcohol Dependence Data Questionnaire, and the World Health Organization encounter forms were used. Appropriate statistical tests were done using SPSS 20. Results: A total of 99 patients were inducted into the study. 44.44% consulted psychiatric services directly. There was a mean time lag of 15 years between the onset of alcohol use and first contact. There was a significant association between sociodemographic characteristics and the pathway chosen. Higher severity of dependence and longer duration of alcohol use were associated with patients visiting psychiatric services indirectly. The main source of referral was family members for the first contact and medical practitioner for a referral to psychiatric services. Conclusion: Understanding the pathway traversed is critical to planning effective interventions in alcohol-dependent patients. Sociodemographic variables seem to be important predictors for the pathway traversed. Although the referral system by medical practitioners is satisfactory, there is a huge gap in accessibility to psychiatric services. There is a need for community awareness programs to prevent time lag.