The interrelationship between stigma and help-seeking is under-researched amongst children and adolescents. This study explored stigma in relation to pathways to care amongst young people putatively in an early stage of increased risk of developing psychotic disorders. 'Pathways to care' was defined as help-seeking and support from informal and formal resources, and increased risk was determined though the presence of persistent psychotic-like experiences and internalizing/externalizing psychopathology.Twenty-nine qualitative interviews were analyzed using thematic analysis. We defined the super-ordinate theme in these data as "conditional disclosure"; a concept reflecting the rules and prerequisites that influenced how/whether participants sought help. Through parallels between these findings and established stigma theory, we examined how these conditions could be interpreted as influenced by stigma. Our findings demonstrate the influence of stigma on young people's perceptions of a range of preclinical symptoms, and on how they seek support for these symptoms.
3Mental health problems are estimated to affect around one in ten children and adolescents (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015). These early difficulties can develop into longstanding issues; indeed, the origins of most adult mental disorders can be tracked back to early life, with onset for around half of lifetime cases occurring before the age of fifteen years, and three-quarters by the midtwenties (Kessler et al., 2007). Early difficulties are also associated with disrupted social functioning, compromised educational attainment, and negative impacts on, for example, adulthood relationships and marriage stability, parenting, physical health, and socio-economic outcomes (A. Goodman, Joyce, & Smith, 2011;Riglin, Petrides, Frederickson, & Rice, 2014). These early difficulties remain untreated for many, and this under-treatment of mental disorders amongst children and adolescents is recognized as a public health concern around the world (Polanczyk et al., 2015). For example, in Great Britain, only 24% of children aged 5-16 years with a diagnosable mental disorder had received treatment from specialist mental health services within the previous year (Green, McGinnity, Meltzer, Ford, & Goodman, 2005).An improved understanding of the mechanisms, stages and patterns underlying young people's helpseeking and service use, and the potential barriers to these processes, could inform strategies aiming to reduce this treatment gap.One potential barrier to receiving care is mental-health related stigma. Stigma has been defined as the situation of a person disqualified from social acceptance due to possessing a deeply discredited attribute, which reduces the stigmatized individual from a whole and usual person to a tainted and discounted one (Goffman, 1963). This definition outlines that, in the case of mental illness, this attribute reflects a blemish on the individual character. Stigma has been conceptualized in many ways. For example, one freque...