• Planned follow-up not attended by 37.5%

Despite the majority seeking help for psychiatric illnesses from allopathic practitioners, there is a substantial delay in presenting to psychiatric services.

These findings were made in a poster presentation on an “Audit on the pathways to care among attendees of a specialised child psychiatry unit in Sri Lanka” which was authored by T.H.R. Samanmalee and D.M.A. Dahanayake (both attached to the Colombo University’s Medical Faculty’s Psychiatry Department), and S.H. Somadasa (attached to the Lady Ridgeway Hospital for Children in Colombo [LRH]), and published in the Ceylon Journal of Medical Science’s 58th volume’s first issue by the Colombo Medical Congress Editorial Board of 2021 in December 2021.

Help-seeking behaviours for psychiatric illnesses vary across cultures, influenced by stigma and various beliefs. 

Samanmalee et al. conducted an audit using paper-based clinic records of new registrants at the Colombo University’s Psychiatry Unit at the LRH, from October to December 2020. A total of 64 records were included. 

The mean age at presentation was 9.3 years, with the age ranging from 2-14 years. The majority were boys (59.4%). Most resided in the Colombo District (64.1%) with 82.8% living in nuclear family environments. The majority had initially sought help from Western medical practitioners (89.1%) with 4.7% first seeing a consultant psychiatrist while 3% had initially seen alternative practitioners.

The first contact with a psychiatrist was in the private sector for 14.1%. The majority were referred to this clinic by the outpatient department following presentation by concerned parents (51.6%), while 28.1% and 15.6% were referred by paediatricians and neurologists, respectively. Judicial referrals accounted for 3.1%. 

Two children were brought within one day of the occurrence of symptoms, while one child presented to the service 7.67 years after the onset of symptoms. The average time between the onset of symptoms and presentation was 14.15 months. A total of 53 (82.8%) received a psychiatric diagnosis with 48.4% having a primary externalising disorder, 21.9% having developmental disorders, and 12.5% having emotional disorders with 31.3% having a co-morbid medical diagnosis. Non-pharmacological management was prescribed for 73.4%. Planned follow-up was not attended by 37.5%.