title: Social network as a determinant of pathway to mental health service utilization among psychotic patients in a Nigerian hospital.
abstract: OBJECTIVE
  The main objectives of the study were to determine the relationship between social network and pathway to service utilization among psychotic patients.
  
  
  METHODS
  This descriptive study was carried out in a psychiatric unit in a general hospital in South West Nigeria. Using structured questionnaires, primary data were collected from 652 psychotic patients on their social network, health behaviors and pathway to current service use. Logistic regression analysis was used to assess the effect of social network on patients' use of services, controlling for sociodemographics, health and functional status.
  
  
  RESULTS
  Mean age of the respondents was 29.0 ± 7.5 years, range 14-58 years, males constituted 52.6%. Regarding pathway to services, alternative sources of care such as priests, spiritualists, natural therapists, herbalists, was the first port of call for 78.9% of respondents. Family dominated the social network in 51.1% of patients. The presence of some social network and social support structures were significantly associated with the use of general medical and specialty psychiatric services for patients with schizophrenia (P = 0.03), schizoaffective disorder (P = 0.02), bipolar I disorder (P = 0.01), but not with major depression and symptoms of psychological distress.
  
  
  CONCLUSIONS
  Findings indicate that social support and social network enhanced utilization of mental health services for psychiatric patients except for those with psychotic depression or those with symptoms of psychological distress. In addition, alternative sources of care are still relevant in mental health service delivery in South West Nigeria.
authors.affiliation: Department of Psychiatry, University College Hospital, Ibadan, Nigeria. victorlash@yahoo.com
authors.forename: Victor O
authors.initials: VO
authors.lastname: Lasebikan
authors.forename: Eme T
authors.initials: ET
authors.lastname: Owoaje
authors.forename: Michael C
authors.initials: MC
authors.lastname: Asuzu
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy; D002977:Clergy; D003865:Major Depressive Disorder / Q000628:therapy; D005195:Family Relations; D005260:Female; D033062:Friends; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009549:Nigeria; D010342:Patient Acceptance of Health Care; D011618:Psychotic Disorders / Q000628:therapy; D012559:Schizophrenia / Q000628:therapy; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult