Exploring personal accounts of the facilitators and barriers to seeking help for first-episode psychosis (FEP): a meta-ethnography

Abstract

Background: Identifying facilitators and barriers to help-seeking for first-episode psychosis (FEP) is a topic growing in research and clinical interest, particularly lived experience perspectives. This meta-ethnography aimed to synthesize the findings of qualitative studies that explored personal accounts of help-seeking for FEP. Methods: A meta-ethnography was conducted: seventeen primary articles were identified reviewed, synthesized and interpreted. Results: The synthesis indicated a chronological process–initially most people did not seek help and attributed their experiences to other stressors. As FEP intensified, uncertainty grew about their initial interpretations, leading to the generation of alternative explanatory frameworks as a form of sense-making. This led to or delayed help-seeking, depending on the types of involvement from significant others and services. If effective help was not sought early enough, most participants experienced a “tipping point”, leading to urgent psychiatric and medical intervention. Throughout, individual, gender and ethnic differences played a role in facilitating or delaying help-seeking. Discussion: FEP and help-seeking appear to be a process affected by, and related to, intertwining intra- and interpersonal, cultural, individual and systemic roles.