Pattern of Presentation and Treatment Outcomes among Patients Attending Psychotherapy Services in a Primary Health Care Centre in Belize

Aims: To determine the pattern of mental health presentation and outcomes among patients accessing psychotherapy services in a primary health care centre.

Study Design: This is a cross sectional descriptive study with mix qualitative and quantitative methods.

Methodology: The quantitative method used retrospective review of records of 157 new clients who accessed psychotherapy services between January 2022 and December 2023 at Port Loyola health centre in Belize city. The qualitative method used in-depth interviews of 20 patients randomly selected from the clinic registers. Factors associated with treatment outcomes (discharged/ dropped out) were determined using bivariate analysis with chi-square test and p value < 0.05 was considered statistically significant. The qualitative data was analysed using content analysis and the result organized into themes.

Results: Depressive episodes (51%) and anxiety disorder (33%) were the most frequent diagnosis. Most patients (40%) were referred by other health workers, followed by self- referral (20.5%). Sixty-nine (43.8%) of the clients were discharged [ those who successfully completed planned psychotherapy intervention], 11(15%) still in the program, 45(28.8%) dropped out and 19(12.3 %) were referred for further mental health services. Discharge was significantly associated with increased age, number of follow up visits, diagnosis and being employed, while drop out was associated with low level of education. Confidence in the service providers, insight, stigma and socioeconomic factors also determined treatment outcomes.

Conclusion: The study supported the existing literature advocating for the integration of psychotherapy into primary health care identified as the most viable way of closing the treatment gap and ensuring that people get the mental health care they need.