title: Reducing treatment delay for early intervention: evaluation of a community based crisis helpline.
abstract: BACKGROUND
  A limited number of studies have assessed the pathways to care of patients experiencing psychosis for the first time. Helpline/clinic programs may offer patients who are still functional but have potential for crisis an alternative that is free from judgment.
  
  
  METHODS
  In this study we report on patient calling a round-the-clock crisis helpline for suicide prevention supported by psychiatric facilities in Mumbai, India. Chi-square and test of mean differences were used to compare outcomes between first-episode patients and those with a previous history.
  
  
  RESULTS
  Within five years, the helpline received 15,169 calls. Of those callers, 2341 (15.4%) experienced suicidal ideation. Two hundred and thirty four patients opting for counseling lasting 12 months agreed to a psychiatric assessment. Of those, 32 were fist time psychosis sufferers, whereas, 54 had previously been psychotic. Of all psychiatric assessments, the clinic received 94 patients with 'first-episode psychosis'. We found that the duration of illness was significantly shorter (17 vs. 28 months) and suicide attempts were fewer (16 vs. 21) in first-time psychosis sufferers compared to those with a treatment history.
  
  
  CONCLUSIONS
  We conclude that some first-episode patients of schizophrenia and other disorders do access services by using helplines. We also argue that helplines may be somewhat immune to stigma, allowing patients a safe alternative when finding help.
authors: Department of Psychiatry, Silver Mind Hospital and Mental Health Foundation of India, (PRERANA Charitable Trust) Mumbai, University of Western Ontario, London, Canada. dr.amresh@gmail.com.
authors: Amresh K
authors: AK
authors: Shrivastava
authors: Megan E
authors: ME
authors: Johnston
authors: Larry
authors: L
authors: Stitt
authors: Meghana
authors: M
authors: Thakar
authors: Gopa
authors: G
authors: Sakel
authors: Sunita
authors: S
authors: Iyer
authors: Nilesh
authors: N
authors: Shah
authors: Yves
authors: Y
authors: Bureau