title: "There are too many steps before you get to where you need to be": help-seeking by patients with first-episode psychosis.
abstract: BACKGROUND
  There has been substantial research on pathways to care in first-episode psychosis (FEP); however, few studies have used a qualitative research paradigm or have been done from the perspective of the person experiencing the psychotic episode.
  
  
  OBJECTIVE
  We sought to describe the experiences of patients with FEP on their pathway to care and to identify factors that help or hinder help-seeking efforts.
  
  
  METHODS
  Using a qualitative descriptive approach, we conducted semi-structured interviews with 16 patients recruited from an early intervention program. Data were analyzed using content analysis to organize the findings into themes.
  
  
  RESULTS
  Self-stigma and a pervasive lack of knowledge regarding the symptoms of psychosis and availability of services were barriers to help-seeking. Participants highlighted the crucial role of significant others in initiating the help-seeking process. Participants typically described a complex series of contacts along the pathway to care which resulted in feelings of being misunderstood and losing control, but many individuals identified unexpected benefits of their experience.
  
  
  CONCLUSIONS
  Our findings suggest a shift in the philosophy and orientation of service delivery towards the creation of services that address these concerns and are relevant to the young people who utilize them.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, Montreal, Quebec, Canada. kelly.anderson@mail.mcgill.ca
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Anderson
authors.forename: Rebecca
authors.initials: R
authors.lastname: Fuhrer
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Malla
mesh_terms: D002170:Canada / Q000208:ethnology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D011618:Psychotic Disorders / Q000453:epidemiology*; D055815:Young Adult