Abstract
Purpose: Enhancing early help-seeking is important for early intervention in psychosis. However, knowledge is limited about those help-seekers who are not initially found to have psychotic symptoms when assessed in services aiming at psychosis detection and, thus, deemed ineligible for early intervention of psychosis programs. We aimed to examine clinical diagnostic and socioeconomic pathways of help-seekers accessing an early detection of psychosis service with referral-free access. Specific focus was on the help-seekers initially assessed not to have psychotic symptoms, considered the non-cases, and to examine potential differences and similarities between non-cases and cases (i.e., those initially assessed to have psychotic symptoms).Methods: We followed 450 help-seekers assessed by a free-of-referral early detection of psychosis team in national registers for up to 4 years. We examined clinical diagnoses and status of not in education, employment, or training (NEET) before and after contact with the team.Results: Of the non-cases, 46% were referred to mental health services by the early detection of psychosis team for evaluation of other mental disorders, and 15% of these were subsequently diagnosed with a non-affective psychotic disorder during follow-up of 12–52 months. Prior to current help-seeking, 39% (n = 174) of the help-seekers had had contact with other mental health services. Nearly a quarter of help-seekers were NEETs at the time of assessment; the number increased during follow-up, both for cases and non-cases. Of the cases, 58% were subsequently clinically diagnosed by mental health services. Those seeking help who had no previous contact with mental health services were more frequently diagnosed with a non-affective psychotic disorder during follow-up (p = 0.05).Conclusion: Referral-free services to promote early detection of psychosis seem a valuable add-on to established pathways, allowing early intervention in psychosis. Our results point to an unmet mental health service need among non-cases; overall, in our sample, independent of case status, social functioning was markedly affected. Our results have implications for future focus in early detection of psychosis. Offering intervention to non-cases within the service has the potential to be cost effective, e.g., if a timely and targeted intervention reduces repeated contacts in other mental health services and social services.
Highlights
Programs that intervene early in psychosis are widely acknowledged to improve treatment response and give greater patient satisfaction with treatment [1]
We found no significant difference between cases and non-cases in mental health service use preceding assessment, NEET-status, age, or sex among helpseekers clinically diagnosed with a non-affective psychotic disorder in follow-up
The results showed that a substantial part of the non-cases became cases, i.e., those individuals who were assessed not to have psychotic symptoms at the initial assessment were subsequently diagnosed with a nonaffective psychotic disorder during the follow-up of a maximum of 4 years and 4 months and a minimum of 12 months on individual level
Summary
Programs that intervene early in psychosis are widely acknowledged to improve treatment response and give greater patient satisfaction with treatment [1]. There is substantial delay in establishing contact with mental health services after the psychotic symptoms emerge [2,3,4]. Different initiatives have been launched through the services in an attempt to promote help-seeking behavior, for example, raising awareness in the general population of the signs and symptoms of psychosis; educating professionals who have contact with adolescents and young adults, such as teachers and social service workers, to recognize psychotic symptoms; and reducing barriers to accessing treatment [4, 10]. Young adults experiencing a first-episode psychosis are often socially disconnected at the time of service access [12, 13], and delay in accessing early intervention has been found among first-episode psychosis individuals being not in education, employment, or training (NEET) [14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
