Help-seeking behavior among persons with first-episode psychosis (the TOP study)

Lene Halling Hastrup1, Ulrik Helt Haahr1, Jens Einar Jansen1, Erik Simonsen1; 1Psychiatric Research Unit, Region Zealand Psychiatry, Denmark

Objective: Focus on early detection and reduction of treatment delay in first-episode psychosis (FEP) has led to an increasing interest in pathway to care. Pathways to care are diverse and varied and may involve non-health agencies like social services, school counselors, religious agencies, and negative pathways as emergency services and police. These determinants vary depending on the social, cultural and health system context. Little is known about the association between determinants of pathways to care and DUP. Previous studies found inconsistent result on the relationship between socio-demographic factors and pathways to care. This study analyzes the impact of demographic and service level factors on DUP. Methods: 1266 patients was diagnosed with a first-episode psychosis (ICD10 F20.0-20.99) in the Danish National Indicator Project during 2009-2011. We combined the study population with data from national administrative registers. Data on inpatient and outpatient psychiatric treatment, contacts to GP’s and medical specialists, prescription medication, and criminal charges was included. Results: Only one third of patients had a DUP below 6 months. More than 90% of the patients had contact with mental health services and the General Practitioner during the year before FEP. Also 16.4% were in contact with the police. When controlling for all other factors in the study, short DUP (less than 6 months) was associated with younger age and having no criminal charges during one year before first episode of psychosis. Conclusion: The study found that mental health services and the GP are important factors on the patients’ pathway to care.

Topic Area: Service System Development and Reform

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