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Family Experiences Prior to the Initiation of Care for First-Episode Psychosis: A Meta-Synthesis of Qualitative Studies

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Abstract

Objectives

This study systematically reviewed existing qualitative evidence of family members’ experiences prior to the initiation of mental health services for a loved one experiencing their first episode of psychosis (FEP).

Methods

A meta-synthesis review of published peer-reviewed qualitative studies conducted between 2010 and 2019 were included. Keyword searches were performed in four electronic databases and the reference lists of primary manuscripts. Two independent reviewers used the Critical Appraisal Skills Programme (CASP) qualitative checklist to assess methodological quality of each study.

Results

A total of 365 articles were initially identified and 9 were articles identified in a secondary review and literature search. A total of 21 met inclusion criteria. Of those included in this review 169, mothers were the primary family to recall experiences. The meta-synthesis identified four major themes related to family member experiences prior to the initiation of mental health services for FEP: the misinterpretation of signs, the emotional impact of FEP on family members, the effect of stigma on family members, and engaging with resources prior to mental health services for FEP.

Conclusions

Additional research is needed to develop healthy communication strategies that effectively deliver educational information about psychosis. This meta-synthesis also identified the need to understand help-seeking behaviors among families of those with FEP in effort to reduce the duration of untreated psychosis and improve pathways to care often initiated by a family member.

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Acknowledgements

Authors would like to thank Behavioral Health Innovations’ undergraduate research assistants J.W. and A.D. in helping with literature searches and creating tables for this manuscript.

Author Contributions

O.O. and S.C. designed, screened, reviewed and wrote the first draft of the manuscript. E.F., B.S., and M.G.M. edited and provided feedback on all drafts of the manuscript. All authors contributed to reviewed drafts and approved the final version of the manuscript.

Funding

This study was supported by K01MH117457 from the National Institute of Mental Health, R25DA035163 from the National Institute on Drug Abuse, and R01AA020248 and R01AA020248-05S1 from the National Institute on Alcohol Abuse and Alcoholism. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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  1. Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA

    Oladunni Oluwoye, Elizabeth Fraser, Bryony Stokes & Michael G. McDonell

  2. Department of Nursing and Healthcare Leadership, University of Washington, Tacoma, WA, USA

    Sunny Chieh Cheng

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  1. Oladunni Oluwoye
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  2. Sunny Chieh Cheng
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Correspondence to Oladunni Oluwoye.

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Oluwoye, O., Cheng, S.C., Fraser, E. et al. Family Experiences Prior to the Initiation of Care for First-Episode Psychosis: A Meta-Synthesis of Qualitative Studies. J Child Fam Stud 29, 2530–2541 (2020). https://doi.org/10.1007/s10826-019-01695-z

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