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A plethora of studies have documented evidence on morbidity patterns and treatment-seeking behaviour among older persons in India. However, so far no attempt has been made to understand differences in the morbidity prevalence rates and utilization of health care services among older adults between religion groups in India. The purpose of this paper is to make an effort in this direction.

Multivariate logistic regression models were fitted to examine the association between socio-demographic conditions and morbidity prevalence and health care-seeking behaviours among the two religion groups: Hindu and Muslim. Data from the 60th round of the National Sample Survey in 2004 were used.

This study provided interesting evidence that, overall, the morbidity prevalence rate was higher among Muslim older persons than their Hindu counterparts by seven percentage points and Hindu scheduled caste (SC) and scheduled tribe (ST) counterpart population (compared to SCs eight percentage points, and STs 20 percentage points); income had no association with the burden of disease among Muslim older population – an older person belonging to the first income quintile was equally likely to report ill-health as an older person of the fifth income quintile. However, despite the low socio-economic status, Muslim older persons were more likely to seek treatment for ill-health compared to Hindu older persons but spent less money for treatment. Also, loss of household income due to sickness was greater among Muslim compared to Hindu older adults.

The findings of this study are important to support the policy makers and health care providers in identifying individuals “at risk” and could be integrated into the current programs of social, economic and health security for the older persons.

This paper considers parents who misuse substances. The potential impacts of their substance misuse on their ability to parent effectively and safely (parenting capacity) are explored, as are some of the barriers many parents face when attempting to seek treatment for problematic substance misuse. The terms ‘use’ and ‘misuse’ are used interchangeably in this paper and ‘substances’ refers to alcohol, illicit drugs and overuse of prescribed medicines. It is important to make the distinction between parents whose use of substances does not constitute dependency and might be best described as ‘recreational or hazardous’. Such individuals might not seek treatment and estimates of prevalence rates of use among this cohort are difficult as they remain hidden from services. Parents who might already be in treatment services or who might be seeking treatment might be described as ‘problematic or dependent’ although presentation at services is neither necessary nor sufficient to assume that the individual's misuse of substances is problematic or indicative of a dependency. The use of substances is associated with numerous harms to the individual: psychologically, socially, interpersonally and physically, and is a risk factor towards negative parenting practices. The use of substances in itself is not an indication of neglectful or harmful parenting, as many parents who use substances have adequate parenting skills, however, it is more frequently associated as a risk rather than a protective factor when considering potential harms. Most of the research refers to mothers although we are aware that some fathers may have sole parenting responsibility for their children. Parents, in particular mothers, face many barriers when trying to access substance misuse treatment services. When they are in treatment, services often lack the skills and experiences to be able to balance managing child protection issues and engaging the parent in treatment. A full review of the issues associated with parenting and substance misuse is beyond the scope of this paper and the reader is referred to Fowler (2003), Cleaver et al (1999), Velleman and Templeton (2007) and Day and George (2005) and the British Psychological Society's Child Protection Portfolio (2007) for further discussion.

The purpose of this paper is to identify the effect of depression symptoms and their associated severity on reducing treatment sought for chronic medical conditions in respondents living in a low-/middle-income country.

Data for this paper are provided by the national cross-sectional World Health Survey (2003) completed in Pakistan. The authors constructed two samples: one reporting an angina diagnosis (n=150) and another an arthritis diagnosis (n=176), each reporting two or more respective disease symptoms. Logistic regression models, after controlling for confounding variables, were performed to predict treatment received in the last two weeks for respondents’ respective disease.

In respondents with angina, depression severity significantly reduced the likelihood of angina treatment received in the two weeks before survey; depression treatment significantly increased this likelihood. In respondents with arthritis, no psychopathologic variables predicted arthritis treatment received.

This paper works to elucidate the constructs underlying the heavy chronic disease burdens, we currently witness in low-/middle-income countries. As the authors’ design is cross-sectional, future research would benefit from using longitudinal designs to further investigate the relationship between these morbidities.

These findings encourage further collaboration between medical and mental health professionals to develop stratified treatment strategies, especially in potentially underdeveloped settings, such as Pakistan. This paper also encourages the development of policy intended to provide residents of Pakistan and countries in similar socioeconomic positions with more medical and psychiatric treatment services.

This paper is unique in identifying the relationship between these morbidities in a large, population-based sample of respondents from a low-/middle-income country, Pakistan.

There is a paucity of comparative literature on pathway to care among patients with co-occurring disorders and those with only substance use disorders. This paper aims to compare the pathways to care among patients with co-occurring disorder and those with only substance use disorders.

A cross-sectional observational study was carried out on male treatment seekers at a tertiary care substance use disorder treatment center in India. Participants were recruited in two groups, those with co-occurring psychiatric and substance use disorders and those with only substance use disorders. The two groups were matched for age and socio-economic status.

A total of 189 subjects with co-occurring psychiatric and substance use disorders and 197 subjects with substance use disorders only were recruited. Psychiatric services were the most common first point of care. However, a larger proportion of the subjects in the co-occurring disorder group received the first care from faith healers, while a greater proportion received first care from the therapeutic communities in substance use disorder only group. Initial care was sought mostly following suggestion from the family members in both the groups. The time to treatment for substance use disorders did not differ between the two groups, though the treatment seeking for substance use disorder was more delayed than that of psychiatric disorder in the co-occurring disorder group.

The findings shed light on the pathway of care followed in India and is a matter of further research.

Expansion of services and dissemination of information about psychiatric disorders and substance use disorders can provide timely care to patients with substance use disorders and co-occurring disorders.

The findings have a social implication as well. More awareness is needed currently in India for timely treatment of dual disorders.

The paper is an original research by the authors. The data were collected from the participants who reported to the dual diagnosis clinic. The findings are important as they tell us about the current understanding of dual diagnosis by the general public.

Public safety (communicators; e.g. 9-1-1, police, fire and ambulance call-takers and dispatchers), like many other public safety personnel (e.g. police, paramedics), (re)suffer operational stress injuries (OSIs) that are too often hidden and at a prevalence higher than the general population. Unfortunately, there are very little data for OSI rates in Canadian communicators. To the authors’ knowledge, this is the only pan-Canadian study focusing on organizational culture, and its potential influence on OSIs, within the communicator context.

The authors conducted a 179-item online survey of Canadian communicators comprising 17 validated screenings for occupational stress injuries and symptoms and four open-ended questions relating to their agency's organizational culture. The authors thematically analysed participants' open-ended responses and their screening scores.

A semi-grounded thematic approach revealed that managers and supervisors were significant contributors to negative perceptions (n = 165) of organizational culture, potentially resulting in or worsening existing OSIs. Specifically, leadership was viewed as ineffective, inconsistent, unsupportive, abusive and toxic, with limited understanding of communicator roles. Communicators described feeling devalued, particularly when leaders fail to recognize communicator OSIs, which can perpetuate stigma. Conversely, positive leaders (n = 24) were described as supportive, communicative and encouraging.

The findings suggest that while leadership behaviours are a key factor in employee well-being, it varies considerably across agencies, impacting treatment-seeking behaviours. The authors’ new understandings of leaders' roles in OSIs may help reduce the frequency and severity of communicator OSIs, helping ensure that emergency services are delivered to Canadians.

This paper describes the development of a novel integrative self-directed treatment tool which uses cognitive behavioural therapy techniques to reduce anxiety symptoms in patients presenting to treatment for alcohol-related problems. More specifically, the purpose of this paper is to explore patient and health practitioner perceptions of the booklet, in order to determine its suitability and utility in the context of existing alcohol treatment services. The extent of cross-informant agreement between patient and health practitioner responses is also examined.

This research utilises a cross-sectional qualitative research design using semi-structured interview methods with patients presenting to hospital for alcohol-related diseases/illnesses/accidents/injuries (n=15) and practitioners (n=10) working at inpatient, outpatient and residential substance treatment facilities.

The present study found that the majority of patients (80 per cent) and practitioners (90 per cent) expressed a motivation to utilise the proposed booklet, agreeing that the booklet was a practical, achievable and educational resource for patients suffering from co-occurring anxiety symptoms in substance abuse facilities. Participants outlined limitations of the resource, suggesting that the booklet would be most suitable for patients with moderate to high cognitive ability, who also exhibit a motivation to change alcohol consumption and have access to additional support.

Findings from the present study suggest that the booklet may be most effective in improving treatment accessibility and patient treatment seeking behaviours; rather than reducing practitioner-patient contact.

This paper focuses on the development and utility of a novel resource suitable for substance abuse treatment facilities. The findings and feedback produced from the present study can assist with modifications of the intervention and in improving the effectiveness of future trials.

Schizophrenia is a devastating illness with a chronic and relapsing course. While Western countries may endorse, biological and psychosocial causes more commonly than supernatural causes, non-western cultures like Nigeria in contrast, tend to endorse supernatural causes. Belief in supernatural causes has been reported to have consequences for treatment seeking behavior. This study aimed to examine the causes of schizophrenia reported by family members of outpatients with schizophrenia in a neuropsychiatric hospital in Midwestern Nigeria. In this study, we recruited a convenient sample of 200 consecutive caregivers of patients visiting the outpatient department of the Psychiatric Hospital, Benin City, Nigeria. These primary caregivers were unpaid relatives who provided support to patients. The patients were service users who fulfilled the diagnostic criteria of the International Classification of Disease [ICD-10; World Health Organization 1993] for schizophrenia and had been on treatment for at least two years. Majority (72.0%) of caregivers endorsed supernatural causes as most important in the etiology of schizophrenia, while 28.0% endorsed natural causes. Every participant without formal education endorsed supernatural attribution. In our study, it was evident that participants embraced multiple causal attributions for schizophrenia.

People who experience mental illness often demonstrate limited help-seeking behaviours. There is evidence to suggest that media content can influence negative attitudes towards mental illness; less is known about how media impacts help-seeking behaviours. The purpose of this study is to identify if media plays a role in people’s decisions to seek help for their mental health.

The databases Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, Social Sciences Full Text [H.W. Wilson] and Soc Index were systemically searched for papers in the English language that investigated the link between media and help-seeking for mental illness.

Sixteen studies met eligibility criteria. There was some evidence to suggest that various forms of media – including video and online resources – can positively influence help-seeking for mental health. Print media had some limited effect on help-seeking behaviours but was weaker in comparison to other forms of media. There was no evidence to suggest that media discourages people from seeking help.

This review identified that, given the heterogeneity of the included papers, and the limited evidence available, there is a need for more focused research to determine how media impacts mental health-related help-seeking behaviours.

The purpose of this paper is to explore the wider societal issues that can impact on the success of a TB programme.

The paper is a qualitative study of the experiences of people involved in a community‐based DOTS programme in Lubombo, Swaziland, involving patients, DOT treatment supporters, clinic nurses and other key informants.

The paper finds that study participants spontaneously raised two main societal issues, which had major impact on the success of the TB programme: health beliefs and poverty. It is seen that health beliefs can have a major impact on treatment‐seeking behaviour and outcomes of TB treatment. Problems related to poverty were of two main types: insufficient funds to attend for review, and lack of food whilst on TB treatment.

This paper discusses why these issues, although strictly outside the remit of the health services, are important factors to consider when implementing TB programmes. It suggests further research that may help break the link between TB and poverty (particularly relating to food insecurity) and recommends considering local health beliefs when dealing with individuals and the community. Neither the impact of health beliefs nor the impact of poverty are new ideas, yet these issues tend to be forgotten by quantitative researchers who perhaps understandably focus on issues that may be perceived as being easier to measure. This paper serves to remind one of their importance and to illustrate the value of qualitative research in highlighting them and ensuring that issues that are important to participants are not neglected.