Duration of Untreated Psychosis (DUP) and Pathways to Care in Patients With First- and Multiple Episodes of Psychosis in Nordland - a Study of the Components of DUP in a Rural Mental Health System

During the 1990s, evidence began to emerge of the long duration of untreated illness prior to receiving treatment for patients with psychotic disorders. Studies across the world on first episode psychosis have consistently found an average of 1 - 2 years between the onset of psychotic symptoms and the start of treatment. Lengthy treatment delay has immediate implications such as unnecessary distress for patients and families, and may also compromise potential recovery when treatment is initiated.By understanding how and why substantial delays occur the investigators may be able to better design interventions to facilitate better earlier treatment. The components of DUP can be conceptualised as comprising 3 distinct intervals: help-seeking delay, referral delay and delay in mental health services. In this study the primary aim is to establish the level of DUP in nordland, and explore the components of this variable. Help-seeking delay will be investigated by interviewing patients presenting at the central mental health hospital in Nordland about their psychosis onset and pathways to care. Referral delay will be investigated by a questionnaire about the referral pratices among GPs in Nordland. Delays in mental health services will be investigated by focus group interviews with leaders and professionals at the 7 community mental health centers in Nordland. This knowledge is believed to be crucial for developing services that can reduce DUP and give this patient population earlier access to adequate treatment.