Early intervention in psychosis: specialized intervention and early case identification

Delays in Treatment: A Literature Review of Pathways to Treatment for Psychosis

“…The literature regarding delays does not include secondary or tertiary (and so on) episodes of psychosis and, as a result, neither does this review. Similarly, literature is scant regarding complications when individuals cease services (i.e., "engagement delay" -- Malla et al, 2010) which disabled this writer from thoroughly exploring this issue as well. Additionally, this literature review does not distinguish between psychosis of different causes (e.g., substance abuse; Bella et al, 2006) or explore how delay may be different depending on origin.…”

“…A delay in treatment may have initially concluded, but if individuals leave treatment before their symptoms subside, the significance on DUP numbers may be skewed by individuals that abandon treatment and continue suffering (Malla et al, 2010;Polari et al, 2009). Additionally, as mentioned previously, the literature consists exclusively of first episode patients while delays in treatment for secondary or tertiary patients are not included (Bhui et al, 2014;McFarlane et al, 2014;Polari et al, 2009).…”

“…However, psychosis seems to present unique challenges that deter this normally healthy behavior, called help seeking (Malla et al, 2010), amongst affected individuals. As Connor et al, (2016) note, help seeking can be upturned due to the unique nature of individual behavior, which can contribute to a lengthier psychotic episode than is necessary.…”

“…Thus, intervening at the level of the affected individual to foster help-seeking behaviors may be too complicated to achieve any ground in lessening the DUP. Malla et al, (2010) Further research into possible unknown individual differences (e.g., education level, learning styles, etc.) and conditions (e.g., comorbid illnesses in the individual, pros vs. cons of different mediums to spread information, etc.)…”

“…As Malla et al, (2010) points out, most studies consider first contacts to be medical professionals: "Family making a referral or bringing a family member to a hospital…[is] not included in [other research]…" (p244). However, one study by Norman et al, (2004) (as cited in Malla et al, 2010) showed half of delay was caused by delayed help-seeking (i.e., individual and family). Participants in the Connor et al, (2016) study showed the same trend -over half of delay was attributed to a lack of help-seeking from individuals and families.…”