Pathways to care through an inner-city mental health service

Abstract

Although traditionally described as taking a linear course, patients' pathways to mental health care might be better summarised in terms of one or more circular sequential Distress-Appraisal-Action cycles. Systematic examination of the referral pathways of patients attending an inner-city psychiatric outpatients clinic revealed that three-quarters of patients' referral routes involved two or three Distress-Appraisal-Action cycles. The remaining 25% of patients whose pathways were characterised by four or more cycles were significantly more likely to have reported changes in defining the problem for which they sought help, to be female, or to be male aged 35 and over.