title: Comparative analysis of pathways to early intervention services and duration of untreated psychosis in two Canadian cities.
abstract: Understanding pathways to early intervention services for psychosis in the local context is crucial, as the structure and organization of services need to be considered. This study compared pathways to early intervention services in two Canadian cities.
  
  
  
  Data on pathways to care and duration of untreated psychosis were collected from 171 people admitted to early intervention services in Toronto (n = 150) and Hamilton (n = 21). We compared the cities on several indicators of pathway to care and duration of untreated psychosis.
  
  
  
  Pathways to care were more complex in Toronto, where people saw a greater number of health care services (median = 6, interquartile range = 3-9) than those in Hamilton (median = 3, IQR = 1-4). General practitioner involvement was higher in Toronto (56.0% vs. 33.3%). We did not find differences in the median duration of untreated psychosis.
  
  
  
  Pathways to early intervention services could be streamlined, and general practitioners may be a target for strategies to improve pathways to care.
authors.affiliation: Health Equity Research Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.
authors.forename: Nina
authors.initials: N
authors.lastname: Flora
authors.affiliation: Departments of Epidemiology & Biostatistics and Psychiatry, The University of Western Ontario, London, Ontario, Canada.
authors.forename: Kelly K
authors.identifier: 0000-0001-9843-404X
authors.initials: KK
authors.lastname: Anderson
authors.affiliation: School of Health Policy and Management, York University, Toronto, Ontario, Canada.
authors.forename: Manuela
authors.initials: M
authors.lastname: Ferrari
authors.affiliation: Health Equity Research Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tuck
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Archie
authors.affiliation: Health Equity Research Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sean
authors.initials: S
authors.lastname: Kidd
authors.affiliation: Health Equity Research Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kwame
authors.initials: K
authors.lastname: McKenzie
mesh_terms: D002170:Canada / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology; D061345:Early Medical Intervention / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008605:Mental Health Services; D011618:Psychotic Disorders / Q000628:therapy*; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: duration of untreated psychosis; first-episode psychosis; pathway to care