Treatment delay and pathways to care in early psychosis

Abstract

Treatment delay and the provision of interventions not specifically indicated for psychosis may be increased in first-episode populations who are younger and have less severe symptoms. Improving literacy about early psychosis in both professionals and families merits greater attention.

Care pathways in the transition of patients between district psychiatric hospital centres (DPCs) and community mental health services

“…Patients with mental health problems experience numerous transitions into and out of hospital . Evidence shows that patients with mental health concerns often share their problems with their primary‐care provider but that primary care providers have mixed success in identifying and managing these concerns on their own . Because patients have a variety of preferences for care and face barriers associated with mental health treatment, this situation suggests the need for easy access to a range of treatments and providers …”

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

“…Ehmann et al, (2014) note that "…the associations between age, pathways, and DUP suggest that it is parents with younger adolescents along with community professionals who need education to improve recognition" (p. 244). The same researchers echo that: "improving literacy about early psychosis in…families merits [sic] greater attention" (Ehmann et al, 2014, p.1) Connor et al, (2016), Corcoran et al, (2007) and Melton & Blajeski, (2017) assert that families can unwittingly delay help-seeking until a crisis point is reached. In some cases, as young people withdraw, families, in turn, became more confused as to what to do rather than seeking help from medical professionals.…”

“…Connor et al, (2016), note that non-psychotic family members can respond to this confusion by turning to other family members to relieve some of their stress and concern -energy that could have been used to help-seek. Additionally, researchers noted that families often mistakenly labeled the symptoms as signs of substance abuse (Ehmann et al, 2014), "acting out", being a teenager, or other developmental stages in adolescence --e.g. "She's going through a teenage phase" --to maintain a sense of normality in the family (i.e., normalization) (Connor et al, 2016, p. 338).…”

“…For instance, Ehmann et al, (2014) note that individuals that see their general practitioner (GP) more regularly receive treatment for psychosis more quickly (p. 241). Connor et al, (2014) note similarly that underdiagnoses or misdiagnoses may be less prevalent if physicians are more familiar with patients.…”

“…Additionally, research reveals that age fifteen is the average age for long-term mental health illnesses (such as schizophrenia or bipolar disorder) to occur (Ehmann et al, 2014;Leavey et al, 2008). Bhui et al, (2014)'s research shows specifically that "patients presenting with psychotic disorders are usually young at first episode" (p. 1).…”