Youth at ultra high risk for psychosis: using the Revised Network Episode Model to examine pathways to mental health care

Boydell, Katherine M.; Volpe, Tiziana; Gladstone, Brenda; Stasiulis, Elaine; Addington, Jean

doi:10.1111/j.1751-7893.2012.00350.x

Cited by 131 publications

(54 citation statements)

References 37 publications

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“…As yet, there are only three small (N’s = 6, 8, 10) qualitative studies of youths at CHR for psychosis 4–6 . Two involved primarily males, who described isolation and difficulty in social interactions, and a reluctance to describe their experiences to others 4–5 .…”

Section: Introductionmentioning

confidence: 99%

“…Two involved primarily males, who described isolation and difficulty in social interactions, and a reluctance to describe their experiences to others 4–5 . A third examined pathways to care among mostly girls in high school, noting the importance of family, community and school 6 . Herein, we aimed to characterize more in depth the subjective experience of at-risk youths, interviewing a relatively large group of 27 ethnically diverse males and females who were participants in a prodromal research program, using phenomenological qualitative research methods.…”

Section: Introductionmentioning

confidence: 99%

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The Subjective Experience of Youths at Clinically High Risk of Psychosis: A Qualitative Study

Ben‐David¹,

Birnbaum²,

Eilenberg³

et al. 2014

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Objective Understanding the experience of individuals across stages of schizophrenia is important for development of services to promote recovery. As yet, little is known about the experience of individuals who exhibit prodromal symptoms of schizophrenia. Methods Audiotaped interviews were conducted with 27 participants at clinical high risk (CHR) for psychosis (15 males; 12 females; mean age 21; ethnically diverse). Phenomenological qualitative research techniques of coding, consensus, and comparison were used. Results Emergent themes differed by gender. Themes for males were feeling abnormal or “broken”; focus on going “crazy”; fantasy and escapism; and alienation and despair, with a desire for relationships. Themes for females were psychotic illness in family members; personal trauma; struggle with intimate relationships; and career and personal development. Conclusions The finding of relative social engagement and future-orientation of females identified as at risk for psychosis is novel, and has implications for outreach and treatment.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Subjective Experience of Youths at Clinically High Risk of Psychosis: A Qualitative Study

Ben‐David¹,

Birnbaum²,

Eilenberg³

et al. 2014

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“…However, understanding coping preferences in relation to the problem profiles the participants reported still provides a useful point of comparison with pathways to care amongst people at clinical high-risk of psychosis. Namely, it is reported that also amongst these groups service use is generally not related to subclinical psychotic symptoms specifically, but a broader set of difficulties (Boydell et al, 2013;Falkenberg et al, 2015).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Even amongst people at clinically defined ultra-high risk of psychosis, prodromal psychosis symptoms are not generally the main reason for service contact. Rather, people in these high-risk groups are reported to present at services primarily due to affective symptoms (Falkenberg et al, 2015), and seek help for problems linked to bullying, peer relationships, self-harm, anxiety and depression, rather than subclinical psychotic symptoms per se (Boydell, Volpe, Gladstone, Stasiulis, & Addington, 2013). Thus, our study's focus on coping in relation to personally meaningful emotional and/or behavioral difficulties was considered an ethically and clinically appropriate approach for exploring pathways to care amongst young people characterized by persisting PLEs; a problem profile reflecting an early stage of putative increased risk of developing psychotic disorders.…”

Section: Data Collectionmentioning

confidence: 99%

Conditional Disclosure on Pathways to Care: Coping Preferences of Young People at Risk of Psychosis

et al. 2016

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The interrelationship between stigma and help-seeking is under-researched amongst children and adolescents. This study explored stigma in relation to pathways to care amongst young people putatively in an early stage of increased risk of developing psychotic disorders. 'Pathways to care' was defined as help-seeking and support from informal and formal resources, and increased risk was determined though the presence of persistent psychotic-like experiences and internalizing/externalizing psychopathology.Twenty-nine qualitative interviews were analyzed using thematic analysis. We defined the super-ordinate theme in these data as "conditional disclosure"; a concept reflecting the rules and prerequisites that influenced how/whether participants sought help. Through parallels between these findings and established stigma theory, we examined how these conditions could be interpreted as influenced by stigma. Our findings demonstrate the influence of stigma on young people's perceptions of a range of preclinical symptoms, and on how they seek support for these symptoms. 3Mental health problems are estimated to affect around one in ten children and adolescents (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015). These early difficulties can develop into longstanding issues; indeed, the origins of most adult mental disorders can be tracked back to early life, with onset for around half of lifetime cases occurring before the age of fifteen years, and three-quarters by the midtwenties (Kessler et al., 2007). Early difficulties are also associated with disrupted social functioning, compromised educational attainment, and negative impacts on, for example, adulthood relationships and marriage stability, parenting, physical health, and socio-economic outcomes (A. Goodman, Joyce, & Smith, 2011;Riglin, Petrides, Frederickson, & Rice, 2014). These early difficulties remain untreated for many, and this under-treatment of mental disorders amongst children and adolescents is recognized as a public health concern around the world (Polanczyk et al., 2015). For example, in Great Britain, only 24% of children aged 5-16 years with a diagnosable mental disorder had received treatment from specialist mental health services within the previous year (Green, McGinnity, Meltzer, Ford, & Goodman, 2005).An improved understanding of the mechanisms, stages and patterns underlying young people's helpseeking and service use, and the potential barriers to these processes, could inform strategies aiming to reduce this treatment gap.One potential barrier to receiving care is mental-health related stigma. Stigma has been defined as the situation of a person disqualified from social acceptance due to possessing a deeply discredited attribute, which reduces the stigmatized individual from a whole and usual person to a tainted and discounted one (Goffman, 1963). This definition outlines that, in the case of mental illness, this attribute reflects a blemish on the individual character. Stigma has been conceptualized in many ways. For example, one freque...

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“…School peers are identified as silent actors in the journey with a role that remains both unclear and complex. Schools must do better in providing safe and fulsome spaces for learning about all aspects of mental health (Boydell, Volpe, Gladstone, Stasiulis, & Addington, 2013).…”

Section: Invoking Journeysmentioning

confidence: 99%

Youth Journeys in Mental Health: Invoking Unique Patient Perspectives

Tilleczek

Bell

Munro

et al. 2017

Canadian Journal of Community Mental Health

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Youth at ultra high risk for psychosis: using the Revised Network Episode Model to examine pathways to mental health care

Abstract: The pathway concept is important to our understanding of how services and supports are received and experienced over time. Understanding this process and the strategies that support positive early intervention on the part of youth and significant others is critical.

Cited by 131 publications

References 37 publications

The Subjective Experience of Youths at Clinically High Risk of Psychosis: A Qualitative Study

The Subjective Experience of Youths at Clinically High Risk of Psychosis: A Qualitative Study

Conditional Disclosure on Pathways to Care: Coping Preferences of Young People at Risk of Psychosis

Youth Journeys in Mental Health: Invoking Unique Patient Perspectives

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