title: The pathways to mental healthcare worldwide: a systematic review.
abstract: OBJECTIVE
  Pathways-to-care studies represent a valid and cost-effective tool to provide information on patients' access to psychiatric care. However, no direct comparison of data concerning the pathways to mental healthcare, at the world level, is available yet.
  
  
  RESULTS
  Data obtained from different countries of the world may offer a global perspective on psychiatric pathways to mental healthcare, highlighting the strengths and weaknesses of different mental health systems and reflecting cultural, economic, social and political differences. We evaluated all studies that used a standardized methodology to describe pathways to mental healthcare of all adult patients, presenting for the first time to psychiatric services.
  
  
  CONCLUSIONS
  Our findings highlight that considerable variations of pathways to mental healthcare across different countries still exist. A consensus on the quality standards of psychiatric care should be reached and actions to ensure their implementation in low-middle income countries should be taken in the near future. The role of primary care doctors and social networks still represent an unsolved issue for psychiatric care worldwide. Stigma and discrimination towards patients with mental illnesses may still represent a relevant limiting factor for equal delivery of mental healthcare.
authors.affiliation: aDepartment of Psychiatry, University of Naples SUN, Italy bDepartment of Psychiatry, University of Medicine and Pharmacy cInstitute of Psychotherapy and Personal Development, Tg. Mures, Romania dInstitute of Psychiatry, Kings College, London, UK eAssociation for the Improvement of Mental Health Programmes, Geneva, Switzerland.
authors.forename: Umberto
authors.initials: U
authors.lastname: Volpe
authors.forename: Adriana
authors.initials: A
authors.lastname: Mihai
authors.forename: Vesna
authors.initials: V
authors.lastname: Jordanova
authors.forename: Norman
authors.initials: N
authors.lastname: Sartorius
mesh_terms: D014943:Global Health; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards / Q000639:trends; D063508:Social Discrimination; D013240:Stereotyping