Factors That Hinder Care Seeking Among People Experiencing First Episode Psychosis

Poster A57, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Bobbi Jo H. Yarborough1, Julie A. Cavese1, Micah T. Yarborough1; 1Kaiser Permanente Northwest Center for Health Research

Objective: Early engagement in evidence-based treatment for psychosis can improve outcomes but service providers need to understand and address the reasons people experiencing first episode psychosis (FEP) avoid or delay care. The goal of this study was to describe reasons care seeking might be postponed, from the points of view of patients, caregivers, and health care professionals. Methods: Twenty-two patients who had received an initial psychosis diagnosis and ten caregivers were interviewed about their FEP experiences and pathways to care. Additionally, 15 administrator or clinician key informants with responsibility for psychosis services in 5 integrated health systems were interviewed and asked to describe how identification and treatment engagement of patients with FEP could be improved. All interviews were transcribed, coded, and analyzed together using thematic analysis. Results: Some individuals did not perceive psychotic experiences as concerning because they were familiar. Among those who were concerned, the desire to make sense of their experiences and avoid detection or stigma, caused some to conceal symptoms or isolate themselves. Caregivers who observed withdrawal often attributed it to typical adolescent behavior, which led to treatment delays. Patient privacy protections also led to delays among young adults. Conclusions: To attract individuals to early psychosis services, outreach and engagement programs need to help individuals and caregivers recognize their experiences as opportunities for care, and design and market services that promote sense-making, offer hope, and reduce stigma and system-level privacy-related barriers to care engagement.

Topic Area: First Episode Psychosis

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