This study explores the time to integrated care contact (TICC) and its determinants among individuals with dual diagnosis (DD) in a multicenter study across India. By examining sociodemographic and clinical factors, this study aims to identify barriers and facilitators for timely integrated care (IC) access.
This secondary analysis included 558 adults diagnosed with substance dependence and co-occurring psychiatric disorders, recruited from nine centers. Sociodemographic and clinical data were analyzed using descriptive and inferential statistics, with generalized linear modeling used to identify predictors of TICC.
The mean TICC was 30.7 months, with delays influenced by marital status, income, education and substance use duration. Separated individuals and those with prolonged substance use histories experienced longer delays. Married individuals with higher incomes accessed care sooner, while common mental disorders were associated with extended TICC compared to severe mental illnesses. The final model explained 30.9% of the variance in TICC, emphasizing the interplay of multiple factors.
The cross-sectional design limits causal inferences, and unmeasured variables like health-care accessibility and stigma may influence TICC. Future research should incorporate longitudinal designs to address these gaps.
These findings highlight the need for targeted interventions, such as stigma reduction and family-oriented approaches, to reduce delays in accessing IC for vulnerable populations.
Improved access to IC can enhance social functioning and health outcomes, reducing the societal burden of untreated DD.
This study provides novel insights into the determinants of IC utilization in low-resource settings, addressing critical gaps in understanding the health-care pathways of individuals with DD in India.
