“I felt like that was a safe place to go”: a qualitative study of help-seeking experiences for early psychosis in primary care

BACKGROUND: Contacts with primary care for early psychosis are common, and there is a need for further insight into help-seeking patterns. AIMS: We sought to describe the help-seeking experiences in primary care for people with early psychosis and their caregivers. METHODS: Using a qualitative descriptive approach, we recruited 22 clients with first-episode psychosis and 13 caregivers from seven specialized clinics to participate in a semi-structured interview. Interviews were audio recorded, transcribed, and coded thematically using conventional content analysis. RESULTS: Help-seeking experiences in primary care were varied. We identified themes describing client- and caregiver-level challenges and supports: impaired mental state, help-seeking decisions and support, and conflicting cultural beliefs and values (between clients and physicians). We also identified physician-level challenges and supports: physician knowledge (perceived as adequate or inadequate), follow-up (close or lack thereof), and supportive relationship with the client and/or caregiver. Finally, we identified health system-level themes: appointment availability and virtual care (described as insufficient). CONCLUSIONS: Interventions to increase help-seeking for early psychosis more broadly may facilitate earlier primary care help-seeking. Primary care physician education, closer follow-up of young people with mental health issues, timely access, and in-person care could improve pathways to care in early psychosis.