Abstract

Background Studies suggest that about one fifth of Nigerian children and adolescents suffer from some form of
mental disorder, In children and adolescents, utilisation of health services is mainly dependent on the
primary carer. Cultural and ethnic differences exist in parental beliefs about illness causation and appropriate
intervention. Aims To examine the factors influencing pathway to child and adolescent mental health care. Method Parents and guardians of patients presenting between 1st January and 31s'December 2006 (n = 232) were asked to fill a questionnaire detailing information, clinical diagnosis, perception of illness causation and history of previous treatment before contact with orthodox care. Statistical analysis was done using SPSS-14 Results The patients were mostly aged 10 years and above (63.4%), male (62.1%) and Christians (79.7%). Thirty nine per cent of parents presented following advice by neighbors/relatives/friends. Referrals from health institutions, schools and religious organizations accounted for 25.4%, 6.9% and 4.3% respectively; 16.4% had consulted spiritual homes, and 37.1% had consulted multiple sources. About 21.6% perceived evil spirits as cause, while 17.2% and 11.6% ascribed illness to febrile convulsion and accident/trauma respectively. There was significant
association between diagnosis and duration before presentation (X2=71.883;df=28;P=0.000).Pathway
to care also varied significantly with mother’s level of education (X‘ =48.02;df=20 - P=0.000) diagnosis (X = 66.953; df=35;P=0.002). There was a significant association between “perceived supernatural causation" and religion (X =7.277,df=1,P=0.007). Conclusion Caregivers commonly consult several treatment options before seeking orthodox care. Spiritual beliefs and maternal education are quite influential in the perception of illness and in help seeking behavior