Determinants of help-seeking behaviour in cases of epilepsy attending a teaching hospital in India: an indigenous explanatory model.

Psychosocial factors determining the choice of health facility in 30 cases of epilepsy attending the psychiatric outpatient department (OPD) of a teaching (referral) hospital in India were studied. The majority of those who chose indigenous healers as their first contact treatment facility did so on the decision of the family. A belief in the supernatural causation of epilepsy combined with family decision was associated with the choice of indigenous health facility. Belief in the physical cause of epilepsy and the participation of social network in decision making were, on the other hand, closely associated with the choice of practitioners of modern medicine. The time-lag between onset of illness and first contact for treatment was short when indigenous healers were consulted first, however these patients usually took a long time to reach the referral centre when they passed through the indigenous healers.