Measuring pathways to care in first-episode psychosis: A systematic review

Singh, Swaran P.; Grange, Tom

doi:10.1016/j.schres.2005.09.018

Cited by 120 publications

(127 citation statements)

References 28 publications

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“…Pathways and access to mental health care are particularly problematic for people from Black and Minority Ethnic background [38,39]. Such groups may not access either CAMHS or AMHS [28] both because of the stigma of mental illness and the perception that services are not culturally appropriate [40].…”

Section: Young People In Special Circumstancesmentioning

confidence: 99%

Transition of care from child to adult mental health services: the great divide

Singh

2009

Current Opinion in Psychiatry

213

190

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Purpose of the review: Adolescents with mental health problems often require transition of care from child and adolescent (CAMHS) to adult mental health services (AMHS). This review is a synthesis of current research and policy literature on transition to determine the magnitude of the problem, barriers at the interface between CAMHS and AMHS and outcomes of poor transition.Recent Findings: Adolescence is a risk period for emergence of serious mental disorders. CAMHS and AMHS use rigid age cut-offs to delineate service boundaries, creating discontinuities in provision of care. Adolescent mental health services are patchy across the world. Several recent studies have confirmed that problems occur during transition in diverse settings across several countries. In physical health, there are emerging models of practice to improve the process and outcomes of transition, but there is very little comparable literature in mental health care.Summary Poor transition leads to disruption in continuity of care, disengagement from services and is likely to lead to poorer outcomes. Some young people, such as those with neurodevelopmental disorders and complex needs, are at a greater risk of falling through the care gap during transition. Services need robust and high quality evidence on the process and outcomes of transition so that effective intervention strategies can be developed.

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Section: Young People In Special Circumstancesmentioning

confidence: 99%

Transition of care from child to adult mental health services: the great divide

Singh

2009

Current Opinion in Psychiatry

213

190

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“…44 First point of contact usually comes via a health professional such as a GP but other contacts can be from religious officials or faith healers or from the criminal justice system. 45 People with psychosis tend to have poor quality of life (QoL). There are widespread problems with social and sexual relationships and in the performance of activities of daily living.…”

Section: Significance Of Psychosis For Patients In Terms Of Ill-healtmentioning

confidence: 99%

Structural neuroimaging in psychosis: a systematic review and economic evaluation

Albon¹,

Tsourapas²,

Frew³

et al. 2008

Health Technol Assess

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“…Pathways to care are influenced by various factors such as gender, cultural and economic background or the social network of the individual [19][20][21][22][23][24]. Social withdrawal, lack of social network, belonging to an ethnic minority, being unemployed or single or having negative stereotypes about psychiatric diseases hinder help-seeking efforts [20,21,23].…”

Section: Introductionmentioning

confidence: 99%

Help-seeking and pathways to care in the early stages of psychosis

Fridgen

Aston

Gschwandtner

et al. 2012

Soc Psychiatry Psychiatr Epidemiol

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Purpose Delay in the treatment of a first psychotic episode can have a negative influence on the future course of the disease. In this context, it is important to examine pathways to care to understand factors contributing to delay in access to adequate care. Methods Using the Basel Interview for Psychosis, we examined the help-seeking behaviour of 61 individuals with an at-risk mental state for psychosis and 37 patients with a first episode of psychosis in a low threshold health care system as part of the Basel early detection of psychosis study. Results The median duration of untreated illness was 3.4 years, of untreated psychosis 12 months. Eighty-six percent of all individuals sought help of some kind before reaching our specialised early detection outpatient clinic, with a mean number of help-seeking contacts of 1.5 prior to referral. The most frequent first help-seeking contacts were family members or relatives n = 24 (26.7 %), close friends n = 17 (17.9 %), psychiatrists in private practice n = 13 (14.4 %) or general practitioners n = 11 (12.2 %). Most patients consulted other health professionals in the early course of the illness before reaching our specialised service; help-seeking with non-medical institutions was rare. Women had more help-seeking contacts than men before contact with our early detection clinic. Conclusions Family, close friends and medical professionals play an important role in help-seeking leading to specialised psychiatric care. Men seek help less often; specific strategies for encouraging young, at-risk men to seek help should be developed.

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Measuring pathways to care in first-episode psychosis: A systematic review

Cited by 120 publications

References 28 publications

Transition of care from child to adult mental health services: the great divide

Transition of care from child to adult mental health services: the great divide

Structural neuroimaging in psychosis: a systematic review and economic evaluation

Help-seeking and pathways to care in the early stages of psychosis

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