Abstract
Background
The establishment of psychiatric services in general hospitals has been driven by various factors, including the prioritization of communicable and non-communicable diseases, the de-institutionalization movement in mental health care, and the geographic and sociocultural barriers to accessing specialized psychiatric services. In Iraq, the stigmatization of mental illness and the under-provision of community-based facilities contribute to the underreporting of mental disorders and the inclination to seek care from non-specialist physicians. This study aims to evaluate the demographic characteristics, patterns of psychiatric disorders, referral and consultation practices, and patient satisfaction in general and specialized psychiatric outpatient settings in Iraq.
Methods
A prospective cross-sectional study was conducted with 650 patients attending outpatient psychiatric clinics at Baghdad Teaching Hospital and Ibn-Rushd (IRH) Psychiatric Hospital from February to July 2021. Data were collected through semi-structured interviews based on DSM-5 criteria and analyzed using Statistical Package for Social Science (SPSS) version 27.
Results
Attendees predominantly presented with major depressive disorder, schizophrenia, and generalized anxiety disorder. Patterns of consultation varied between the two hospitals, with IRH showing a higher prevalence of schizophrenia and chronic cases, while Baghdad Hospital had a higher proportion of first-time visitors. Patient satisfaction was generally higher in the specialized IRH setting compared to the general hospital. The workload was significantly heavier in IRH, reflecting the preference for specialized psychiatric care. The study highlighted the challenges of the mental health system in Iraq, including the impact of political instability, conflict, and underinvestment in healthcare infrastructure.
Conclusion
The study underscores the necessity of enhancing psychiatric services in general hospitals in Iraq to cater to the diverse needs of patients with mental disorders. It emphasizes the importance of addressing the sociocultural stigma and the structural challenges faced by the healthcare system. Integrating psychiatric services within general hospitals could improve accessibility and reduce the burden on specialized facilities, provided that the quality of care and patient satisfaction are ensured.