Health-seeking behaviour of mentally ill patients in Enugu, Nigeria

Aim. To determine the health-seeking behaviour of mentally ill patients in Enugu, Nigeria. Design. A consecutive recruitment of 397 patients receiving treatment at the neuropsychiatric hospital in Enugu was done. Using a structured questionnaire, information was obtained from the respondents including their socio-demographic characteristics, their knowledge of the cause of their mental illness, and the treatment that they first employed, with their reasons for doing so. Results. The age range of the respondents was 15 - 75, with a mean of 31.6 years (SD±11 years). Two hundred and twenty-three (56.2%) respondents were male and 174 (43.8%) were female. Treatment options first employed by respondents were prayer houses (34.5%), followed by psychiatric hospital (32%). The main reasons for the treatment options employed were confidence of cure at the place of treatment (46.3%), ignorance of the existence of a mental health service (14.6%), and the belief that the mental condition was not amenable to orthodox treatment (8.1%). Patients' perceptions of the cause of their ailment most commonly revealed a belief in demonic and spiritual forces. Gender, educational status, attributing of the mental illness to a rational cause, and living in an urban area were significantly associated with the employment of specialist care as the first treatment option. Conclusion. Misconceptions regarding the cause of mental illness still abound among mentally ill patients in Nigeria. Consequently, psychiatric consultation is not usually initially employed, especially in rural areas. Community health education aimed at changing misconceptions, and the integration of mental health services into primary health care services, is advocated.