PATHWAYS TO PSYCHIATRIC-CARE IN ANKARA

This paper describes the pathways that patients take to reach psychiat ric services in Ankara. A total of 582 patients were seen in a calenda r month in seven centres, two of them being child psychiatric clinics. The pathway in Ankara, unlike many other centres in Europe, is domina ted by direct referrals. Only 4 % of patients in our sample contacted their general practitioner (GP) first, compared with 42 % who first sa w hospital doctors and 53 % who came direct. Religious healers appeare d in the pathway of only 1 % of patients, and the delay associated wit h them was longer. Male patients had longer delays than female patient s, and delays were also longer for patients presenting with somatic sy mptoms. Although the availability of psychiatric services is limited, the median time taken to be seen by the psychiatric services after con tacting any carer was only 1 week. The results showed that the referra l system for the mental health services is still far from a GP-based s ystem. The patients presenting with somatic symptoms consulted hospita l doctors more frequently and were delayed more, pointing to the need for the training of hospital doctors, in addition to GPs, in the recog nition and management of common psychiatric dis orders.