Mapping the Continuum of Mental Health Care for Individuals with Acute or Chronic Mental Illness in Udupi District, Karnataka, India: A System Map Approach

Background: According to the World Health Organization (WHO) mental health disorders affect around 970 million people globally. In India, mental health disorders affect 14.6% of the population, further exacerbated by limited healthcare resources. This influences the continuity of care, an essential healthcare process. Objective: This study investigated the continuum of care through mapping of important stakeholders and analysed policies and structures in Udupi District, Karnataka. Methods: In the first phase a collaborative literature search was conducted through electronic databases, including PubMed, Scopus, and Embase, were searched using keywords such as "mental health care," "continuity of care," and "India." Field visits to mental health institutions provided first hand observations and in-depth interviews with seven key informants and stakeholders, contributing to the construction of the system map. This was followed by phase 2 of the study which included the analysis of data and synthesis of findings. Results: Based on the creation of the system map, key actors and policies at global, national and local level were identified influencing the mental health care continuum in Udupi, Karnataka. The continuum of care highlighted both strengths and barriers in mental health service delivery. While numerous services existed, accessibility still remained a significant challenge owing to resource limitations and stigma. Conclusion: Our study mapped the continuum of care of mental health in Udupi, Karnataka, influenced by global, national and regional policies. However, focused community engagement and public-private partnerships may help in bridging the gaps in mental health care.