Service User Perspectives on the Experience of Illness and Pathway to Care in First-Episode Psychosis: A Qualitative Study Within the TOP Project
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Delays in initiating treatment are associated with poor clinical and functional outcomes, yet there remains unclarity as to what facilitates and what acts as barriers to accessing appropriate support for first-episode psychosis. To explore this we examined service users’ views of their illness trajectory and help-seeking behavior. To describe service-users' experiences with and understanding of their illness and pathway to care, including their need for treatment, the role of their relatives and experience with the treatment service. In-depth interviews were conducted with eleven randomly selected service users (median age 20, range 15–24, 6 males, 5 females) diagnosed with a first-episode psychosis and currently enrolled in treatment for this disorder. Fear of stigma, lack of knowledge about mental illness and normalisation of symptoms were barriers to accessing appropriate treatment, while support from significant others and information accessed by internet were reported as important elements in seeking appropriate treatment. The findings regarding barriers to treatment are in accordance with themes found in earlier studies and serve to validate these. Our study highlights the need to include psychological factors such as normalisation of symptoms and fear of stigma when attempting to reduce DUP in early psychosis, in addition to initiatives to reduce service delays. Also, a greater use of the potentials inherent in Internet and social media platforms seems important in this regard.
KeywordsPathways to care FEP Early intervention Psychosis Qualitative
This study was funded by a grant from the Lundbeck Foundation. We thank all the service users who participated in this study, and the staff at Opus for their involvement in recruitment.
Conflict of interest
- 19.Jansen JE, Harder S, Haahr UH, et al.: The role of metacognitions in expressed emotion and distress: A study on caregivers of persons with first-episode psychosis. Clinical Psychology and Psychotherapy n/a–n/a, 2014. doi: 10.1002/cpp.1907.
- 20.Kuipers E, Onwumere J, Bebbington P: Cognitive model of caregiving in psychosis. The British Journal of Psychiatry The Journal of Mental Science 196:259–65, 2010. doi:10.1192/bjp.bp.109.070466.