title: Searching for psychosis: INTREPID (1): systems for detecting untreated and first-episode cases of psychosis in diverse settings.
abstract: OBJECTIVE
  Our understanding of psychotic disorders is largely based on studies conducted in North America, Europe and Australasia. Few methodologically robust and comparable studies have been carried out in other settings. INTREPID is a programme of research on psychoses in India, Nigeria, and Trinidad. As a platform for INTREPID, we sought to establish comprehensive systems for detecting representative samples of cases of psychosis by mapping and seeking to engage all professional and folk (traditional) providers and potential key informants in defined catchment areas.
  
  
  METHODS
  We used a combination of official sources, local knowledge of principal investigators, and snowballing techniques.
  
  
  RESULTS
  The structure of the mental health systems in each catchment area was similar, but the content (i.e., type, extent, and nature) differed. Tunapuna-Piarco (Trinidad), for example, has the most comprehensive and accessible professional services. By contrast, Ibadan (Nigeria) has the most extensive folk (traditional) sector. We identified and engaged in our detection system-(a) all professional mental health services in each site (in- and outpatient services-Chengalpet, 6; Ibadan, 3; Trinidad, 5); (b) a wide range of folk providers (Chengalpet, 3 major healing sites; Ibadan, 19 healers; Trinidad: 12 healers); and c) a number of key informants, depending on need (Chengalpet, 361; Ibadan, 54; Trinidad, 1).
  
  
  CONCLUSIONS
  Marked differences in mental health systems in each catchment area illustrate the necessity of developing tailored systems for the detection of representative samples of cases with untreated and first-episode psychosis as a basis for robust, comparative epidemiological studies.
authors: Health Service and Population Research Department, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK, craig.morgan@kcl.ac.uk.
authors: Craig
authors: C
authors: Morgan
authors: Maia
authors: M
authors: Hibben
authors: Oluyomi
authors: O
authors: Esan
authors: Sujit
authors: S
authors: John
authors: Vikram
authors: V
authors: Patel
authors: Helen A
authors: HA
authors: Weiss
authors: Robin M
authors: RM
authors: Murray
authors: Gerard
authors: G
authors: Hutchinson
authors: Oye
authors: O
authors: Gureje
authors: Rangaswamy
authors: R
authors: Thara
authors: Alex
authors: A
authors: Cohen
mesh_terms: D002391:Catchment Area, Health; D000066505:Help-Seeking Behavior; D006801:Humans; D007194:India; D016488:Medicine, African Traditional; D008605:Mental Health Services; D009549:Nigeria; D010342:Patient Acceptance of Health Care; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D014300:Trinidad and Tobago
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