Exploring gaps in pathways to care for psychosis: rural populations and the voluntary sector

Akarsu, Nazire Ezgi (2024) Exploring gaps in pathways to care for psychosis: rural populations and the voluntary sector. Doctoral thesis, University of East Anglia.

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Abstract

Background: Timely access to treatment, particularly for young people, has been shown to reduce the risk of transition to psychosis and duration of untreated psychosis (DUP). Help-seeking and recognition of symptoms is vital to early detection. Whilst there has been much research into psychosis in urban settings and statutory services’ involvement in early detection of symptoms, the help-seeking experiences of young people from rural populations and voluntary sector involvement is not as well understood.

Methods: A mixed-methods systematic review and narrative synthesis was conducted to synthesise the quantitative and qualitative evidence-base on barriers and facilitators to help-seeking for young people aged 16-25 from rural populations. The empirical study utilised a vignette-based survey to collect data from VSO staff. The Mental Health Literacy Survey was adapted to assess ability to recognise depression, psychosis, and ARMS, appropriate treatment and medicines.

Results: Fifteen studies met the inclusion criteria (n=9 quantitative, n=5 qualitative, n=1 mixed methods). Family was a key facilitator of help-seeking. Stigma from social visibility and difficulty maintaining confidentiality was a barrier due to the interconnectedness of rural communities. Rural male youth were less likely to seek help. Remote interventions to counteract distance were not favourable. In the empirical study, VSOs had the highest recognition of depression (67.7%), then psychosis (39.0%), but lowest recognition of ARMS (8.1%). Traditional psychiatric medications were considered less helpful compared to ‘vitamins/minerals/tonics/herbal medicine’.

Conclusion: Service provision, particularly a commitment to confidentiality requires careful consideration in rural communities. The empirical findings highlight the importance of improving mental health literacy, especially for ARMS, within VSOs to address wider national policy recommendations to improve early detection and treatment for individuals at high risk of psychosis.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences
Depositing User:	Zoe White
Date Deposited:	06 Nov 2024 15:41
Last Modified:	06 Nov 2024 15:41
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97541
DOI:

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