title: Seeking help for first-episode psychosis: a family narrative.
abstract: Delayed help-seeking can have serious consequences for young people with first-episode psychosis (FEP), in terms of treatment response and outcome. Young people's narratives about help-seeking are important to understand why delays occur; however, as the majority of help-seeking is initiated by family members, through a general practitioner (GP), family narratives are also of interest. The aim of this study was to explore help-seeking for FEP, including first contact with a GP.
  
  
  
  A semistructured interview was developed using a topic guide. Framework analysis was used to analyse data and a deductive qualitative method for applied research. The study was set in Birmingham, UK. Participants were interviewed separately by researchers. Joint coding and identification of 14 complete family dyads was then explored for emerging patterns within the family context.
  
  
  
  Family responses to FEP that had an impact on help-seeking behaviour included withdrawal, normalization, stigma, fear and guilt; poor knowledge of availability, and means of access to mental health services was also important. Help-seeking was usually instigated by a family member through a GP, although this was not the case for two of our families, and while contact with GP was generally described as a positive experience for several families, it was hindered by poor communication and lack of engagement.
  
  
  
  Families play a key role in facilitating help-seeking for FEP, but attempts are often derailed by complex family responses to illness. Public mental health interventions should focus on increasing community awareness of psychosis and improving access and alternative routes to mental health services. However, improvements will have little impact unless primary care and other help-seeking sources engage in open and easy dialogue with the families and young people trying to access their specialist services.
authors.affiliation: Birmingham and Solihull Mental Health, NHS Trust Research and Development Unit, Birmingham, UK.|Division of Health and Wellbeing, Warwick Medical School, University of Warwick, Birmingham, UK.|School of Psychology, University of Birmingham, Coventry, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Connor
authors.affiliation: Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Sheila
authors.initials: S
authors.lastname: Greenfield
authors.affiliation: Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Lester
authors.affiliation: Birmingham and Solihull Mental Health, NHS Trust Research and Development Unit, Birmingham, UK.
authors.forename: Sunita
authors.initials: S
authors.lastname: Channa
authors.affiliation: Birmingham and Solihull Mental Health, NHS Trust Research and Development Unit, Birmingham, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Palmer
authors.affiliation: Birmingham and Solihull Mental Health, NHS Trust Research and Development Unit, Birmingham, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Barker
authors.affiliation: School of Life and Population Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Lavis
authors.affiliation: Division of Health and Wellbeing, Warwick Medical School, University of Warwick, Birmingham, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Birchwood
mesh_terms: D000328:Adult; D005190:Family / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D033262:Narration; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011618:Psychotic Disorders / Q000523:psychology*; D036301:Qualitative Research; D055815:Young Adult
keywords: carers; families; help-seeking delays; psychosis; young people