Table 3.
Study outcomes II—Help-seeking contacts across studies
| Authors | Key pathway agents | Common first help-seeking contacts | Common referral sources |
|---|---|---|---|
| Addington et al. [22] | Most common: emergency services (33%), family physicians (23%) Other: psychologists, teachers/counsellors, psychiatrists, family, emergency services, police, clergy, social workers, and friends |
Emergency services (52%), family physicians (18%), psychiatrists (18%) | |
| Anderson et al. [12] | Over 45% of patients had contact with police or ambulance | Emergency services (62%) | Emergency services (74%) |
| Anderson et al. [23] | Primary care physicians are most commonly used overall | Most common: primary care physicians | Most common: inpatient units |
| Archie et al. [24] | Most common: emergency services and primary care physicians, family, doctors/walk-in clinics, clergy/homeopath/other non-medical contacts, psychologists, psychiatrists, school counsellors, psychiatric admissions | Family doctor/walk-in clinic (31%), emergency services (24%), clergy/homeopath (12%) | Psychiatric admissions (40.2%), family doctor/walk-in clinic (14.8%), emergency services (13.8%) |
| Bakare [25] | Neuropsychiatric hospitals, prayer houses, other hospitals, traditional healers, patent medicine stores, roadside medical labs, specialized school for children | Psychiatric hospitals (48%), prayer houses (22%), other hospitals (21%) | Relatives, family, or friends. (92%), other hospitals (7%), prayer houses/faith healing centres (1%) |
| Bekele et al. [26] | Priests, herbalists, nurses, doctors | Priests/holy water (31%), doctors (21.5%), herbalists (4.5%) | Self-referrals (41%) |
| Bhui et al. [27] | Primary care physicians, emergency services, police, community-based health and social care agencies, prisons, psychiatric services, native or religious healers | Primary care physicians, emergency services, and criminal justice agencies | |
| Chadda et al. [28] | Traditional healers, psychiatrists, non-psychiatric doctors, Ayurveda (Indian system of herbal medicine) | Psychiatrists (58%), religious faith healers (30%), physicians (12%) | |
| Chesney et al. [29] | Medical specialists, psychiatrists, private psychiatrists, direct referrals, at-risk clinic, primary care physicians, health professionals, counsellors community health assessment team, police, employers and teachers, other, traditional or religious healers, courts, lawyers | Specialist care (59%), primary care (27%), police (12%) | Thirty patients (3%) were self-referred |
| Cheung et al. [30] | Teachers, counsellors, police, psychologists, psychiatrists, family physicians, emergency services, public health, outpatient psychiatry, other | ||
| Chiang et al. [31] | Self-referral, medical, non-medical and religious, alternative help | Social workers, primary care physicians | Telephone helpline, emergency services, primary care |
| Chien and Compton [32] | Hospital/emergency services, police, outpatient service, family physicians | Psychiatric hospital and emergency (32%), psychiatrists, counsellors, or outpatient mental health clinics (26%), police (20%) | Psychiatric hospitals, psychiatric or general emergency services, police (25%), psychiatrists, counsellors, or outpatient mental health clinics (13.2%), emergency services (7.4%) |
| Commander et al. [33] | Psychiatrists, social workers, police, emergency services, primary care physicians, community psychiatric nurses, other, self | ||
| Compton et al. [34] | Most common: mental health professionals and psychiatric emergency services, general emergency department, primary care physicians, police, other | Mental health professionals (32%), psychiatric emergency services (24%), general emergency departments (20%) | Psychiatric emergency services (36%), mental health professionals (20%), general emergency departments (20%), police (20%) |
| Cougnard et al. [35] | Primary care physicians (32%) | Primary care physicians (37%), psychiatrists | |
| Del Vecchio et al. [36] | Primary care physicians, psychiatrists, neurologists, psychologists, relatives | Primary care physicians (28%), psychiatrists (30%), neurologists (21%) | |
| Ehmann et al. [37] | Relatives/friends, schools, counsellors or crisis line, mental health teams, general physicians, private psychiatrists, hospitals, direct entry | Relatives/friends (52%), primary care physicians (16%), self-referrals (9%), counsellor or crisis line (8%), mental health teams (6%), psychologists (5%) | |
| Etheridge et al. [38] | Primary care physicians, relatives, psychiatrists, teachers, hospitals | Most common by service users: relatives, primary care physicians, psychiatrists, teachers and hospitals Most common by family/carers on behalf of a service user: primary care physicians, school staff, police and emergency services |
|
| Fridgen et al. [39] | Friends, family, psychiatrists, primary care physicians, colleagues, partners, other physicians, psychologists, priests, alternative medicine | Family or friends (46%), private psychiatrists (14%), or primary care physicians (12%) | Outpatient departments, private psychiatrists, other physicians, self-referrals, family |
| Fuchs and Steinert [40] | Most common: mental health professionals (46%), primary care physicians (20%), hospitals (18%), and psychosocial contacts (16%) | Primary care physicians (18%) | |
| Giasuddin et al. [41] | Private practitioners, native or religious healers, other medical facilities, general hospitals | Private practitioner (44%), native or religious healer (22%), direct pathway (16%) | |
| Hastrup et al. [42] | Primary care physicians, inpatient units, outpatient units, and emergency services, other medical specialists | Outpatient services (59%), hospital services (41%) | Emergency services (26%), primary care physicians (22%), hospitals (46%) |
| Hodgekins et al. [43] | Primary care physicians, education services, emergency services, social care, other | Primary care physicians, educational settings | |
| Jain et al. [44] | Faith healers, non-psychiatric allopath care providers, alternative medicine, direct entry, mental health professionals | Faith healers (40%), non-psychiatrist allopath care provider (29%), other psychiatrist (15%) | |
| Judge et al. [45] | Relatives, emergency services | ||
| Kurihara et al. [46] | Most common: traditional healers. Others: primary care physcians, hospital doctors, community health centres | Traditional healers (43%), primary care physicians (7%), direct entry (4%) | Traditional healers (67%), community health centres (17%), and primary care physicians (13%) |
| Lahariya et al. [47] | Faith healers, psychiatrists, allopathic practitioners, traditional healers, other (friends and family) | Faith healers (69%), psychiatrists (9%) | Others (including previous patients), allopathic practitioners |
| Lincoln et al. [48] | Mental health professionals (50%), primary care physicians (17%) | Primary care physicians (36%), psychiatric services (16%), police (12%) | |
| McMiller and Weisz [49] | 52% of all contacts were ‘professional’ (56% for Caucasians, 47% for African–Americans and 42% for Latino) | 45% of first contacts were Healthcare professionals (53% for Caucasians, 32% African American, 30% Latino) | |
| Mkize and Uys [50] | Traditional healers, faith healers, hospitals, police, mental health institutions, primary health care clinics | Primary care physicians (33%), faith healers (20%), traditional healers (20%) | |
| Naqvi et al. [51] | Religious healers, primary care providers, specialists, hospitals doctors, psychiatric services | Self-referrals (49%), hospital or other specialists (20%), Primary care (2.9%) | |
| Neubauer et al. [52] | Physicians, health professionals, mental health professionals, social networks, eating disorder clinics, day clinics | Inpatient treatment (55%), outpatient facility (39%), eating disorder-specific centre (4%) | |
| Norman et al. [53] | Primary care physicians, community or school counsellors, psychologists, social workers, psychiatrists, hospitals, emergency services | Before psychosis: primary care physicians (40%), community or school counsellors (30%), psychologists or social workers (20%) After psychosis, hospital or emergency services (43%), primary care physicians (39%), community (13%) |
Emergency services (49%), private psychiatrists or non-emergency hospital (26%), primary care physicians (15%) |
| O’Callaghan et al. [54] | Primary care physicians, emergency services, counselling services, police, religious organizations, complementary and alternative medical services, and clinic website | Primary care physicians (59%), other, including emergency services (41%) | |
| Phillips et al. [55] | Primary care physicians, private psychiatrists/psychologists, outpatient services, inpatient services, other | Youth access team, generic and mental health services, school and university counsellors and youth housing and employment workers | |
| Platz et al. [56] | In-patient services, primary care physicians, alternative medical practitioners, non-medical counselling services, non-specified professionals | Primary care physicians (34.6%) | General practitioners, private psychiatrists/psychologists, psychiatric outpatient services |
| Reeler [57] | Hospital doctors, traditional healers | Hospital doctors | Hospital doctors |
| Reynolds et al. [58] | Primary care physicians, community-based teams, out of area teams, emergency services, police, prison, child and adolescent mental health teams, specialized services | Primary care physician (43%), emergency services (24%), police (11%) | Post training, 46% were referred by primary care physicians |
| Sharifi et al. [59] | Psychiatrists, primary care physicians, other health professionals, traditional healers, other professional | Psychiatrist (25%), traditional healer (23%) or a primary care physician (18%) | Family (33%), health professionals (32%) and the legal system (17%) |
| Shin et al. [60] | Most common: internet and family members (57%) Other: patients, teachers, physicians, specialized clinic, shelters |
||
| Stowkowy et al. [61] | Primary care physicians, mental health clinics, psychiatrists and other individuals | Primary care physicians (29%), psychiatrists, mental health clinics and social workers, (14% each), Self-referral (11%) | |
| Subramaniam et al. [62] | Primary care physicians, polyclinics, other primary care, hospitals, traditional or religious healers, direct entry, counsellors, police, courts, family, relatives, friends, other | Family, primary care physicians | Family |
| Turner et al. [63] | Primary care physicians, school counsellors, religious ministers, psychiatric outpatient clinics, private psychiatrists, other, mental health services, other health services | Inpatient services (64%), emergency services (16%), general practitioners (7.7%) | |
| Graf von Reventlow et al. [64] | Physicians, psychiatrists, psychologists, nurses, social workers, treatment teams, other counsellors, other healthcare professionals, other professionals | ||
| Wiltink et al. [65] | Primary care physicians, teachers, counsellors, drug and alcohol services, accommodation services, youth health services, emergency services, public hospital, other |