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Early intervention in psychosis services: A systematic review and narrative synthesis of barriers and facilitators to seeking access

Early intervention in psychosis services: A systematic review and narrative synthesis of barriers and facilitators to seeking access
Early intervention in psychosis services: A systematic review and narrative synthesis of barriers and facilitators to seeking access
Background: the duration of untreated psychosis (DUP) continues to be a global priority. Early intervention services were established to reduce treatment delays but have had limited impact. This systematic review examines barriers and facilitators to seeking access to these services, to identify targets for service level change.

Methods: we conducted a systematic review of relevant databases (PsychINFO, MEDLINE, CINAHL, and PsychARTICLES) using pre-defined search terms for psychosis, early intervention, and barriers and facilitators. Given the majority of qualitative studies, a thematic synthesis rather than meta-analysis was indicated.

Results: the search yielded 10 studies. Mental health stigma and discrimination predict DUP, compounded by structural barriers which limit the impact of early intervention services on timely access to recommended treatments. Synthesis of the qualitative studies generated three themes: knowledge, relationships, and stigma. Lack of knowledge, absence of supportive relationships (social and professional), and self-stigma constitute significant barriers to seeking access to early intervention services.

Conclusions: this is the first review of the barriers and facilitators to seeking access to early intervention services. The findings highlight public health and secondary care service targets to expedite access to recommended treatments and thereby reduce the DUP.
barriers, duration of untreated psychosis, early intervention, facilitators, psychosis, qualitative synthesis, systematic review
0924-9338
Tiller, Jacqui
1024cb1e-dc58-4ae3-8ded-d568009f5397
Maguire, Tess
f720bf11-2227-470f-b9bf-b323a59e176c
Newman-Taylor, Katherine
e090b9da-6ede-45d5-8a56-2e86c2dafef7
Tiller, Jacqui
1024cb1e-dc58-4ae3-8ded-d568009f5397
Maguire, Tess
f720bf11-2227-470f-b9bf-b323a59e176c
Newman-Taylor, Katherine
e090b9da-6ede-45d5-8a56-2e86c2dafef7

Tiller, Jacqui, Maguire, Tess and Newman-Taylor, Katherine (2023) Early intervention in psychosis services: A systematic review and narrative synthesis of barriers and facilitators to seeking access. European Psychiatry, 66 (1), [e92]. (doi:10.1192/j.eurpsy.2023.2465).

Record type: Article

Abstract

Background: the duration of untreated psychosis (DUP) continues to be a global priority. Early intervention services were established to reduce treatment delays but have had limited impact. This systematic review examines barriers and facilitators to seeking access to these services, to identify targets for service level change.

Methods: we conducted a systematic review of relevant databases (PsychINFO, MEDLINE, CINAHL, and PsychARTICLES) using pre-defined search terms for psychosis, early intervention, and barriers and facilitators. Given the majority of qualitative studies, a thematic synthesis rather than meta-analysis was indicated.

Results: the search yielded 10 studies. Mental health stigma and discrimination predict DUP, compounded by structural barriers which limit the impact of early intervention services on timely access to recommended treatments. Synthesis of the qualitative studies generated three themes: knowledge, relationships, and stigma. Lack of knowledge, absence of supportive relationships (social and professional), and self-stigma constitute significant barriers to seeking access to early intervention services.

Conclusions: this is the first review of the barriers and facilitators to seeking access to early intervention services. The findings highlight public health and secondary care service targets to expedite access to recommended treatments and thereby reduce the DUP.

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More information

Accepted/In Press date: 12 October 2023
e-pub ahead of print date: 6 November 2023
Published date: 6 November 2023
Additional Information: Publisher Copyright: © The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association.
Keywords: barriers, duration of untreated psychosis, early intervention, facilitators, psychosis, qualitative synthesis, systematic review

Identifiers

Local EPrints ID: 485369
URI: http://eprints.soton.ac.uk/id/eprint/485369
ISSN: 0924-9338
PURE UUID: 836ddba0-ec39-4eec-8cac-266191bb3ec2
ORCID for Jacqui Tiller: ORCID iD orcid.org/0000-0002-5929-7756
ORCID for Katherine Newman-Taylor: ORCID iD orcid.org/0000-0003-1579-7959

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Date deposited: 05 Dec 2023 17:38
Last modified: 18 Mar 2024 03:58

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Contributors

Author: Jacqui Tiller ORCID iD
Author: Tess Maguire

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