service user and carer experiences of seeking help for a first episode of psychosis a uk qualitative study服务用户和看护经验寻求帮助的精神病英国定性研究的第一集.pdf

Tanskanen et al. BMC Psychiatry 2011, 11:157 /1471-244X/11/157 RESEARCH ARTICLE Open Access Service user and carer experiences of seeking help for a first episode of psychosis: a UK qualitative study 1 2 1 1,3 1 3 Sanna Tanskanen , Nicola Morant , Mark Hinton , Brynmor Lloyd-Evans , Michelle Crosby , Helen Killaspy , Rosalind Raine4, Stephen Pilling5 and Sonia Johnson1,3* Abstract Background: Long duration of untreated psychosis (DUP) is associated with poor outcomes and low quality of life at first contact with mental health services. However, long DUP is common. In order to inform initiatives to reduce DUP, we investigated service users’ and carers’ experiences of the onset of psychosis and help-seeking in two multicultural, inner London boroughs and the roles of participants’ social networks in their pathways to care. Method: In-depth interviews were conducted with service users and carers from an early intervention service in North London, purposively sampled to achieve diversity in sociodemographic characteristics and DUP and to include service users in contact with community organisations during illness onset. Interviews covered respondents’ understanding of and reaction to the onset of psychosis, their help-seeking attempts and the reactions of social networks and health services. Thematic analysis of interview transcripts was conducted. Results: Multiple barriers to prompt treatment included not attributing problems to psychosis, worries about the stigma of mental illness and service contact, not knowing where to get help and unhelpful service responses. Help was often not sought until crisis point, despite considerable prior distress. The person experiencing symptoms was