1School of Psychology, University of Southampton, Southampton, UK.
2Psychology Department, Southern Health NHS Foundation Trust, Southampton, UK.
Eur Psychiatry. 2023 Nov 6;66(1):e92. doi: 10.1192/j.eurpsy.2023.2465.
The duration of untreated psychosis (DUP) continues to be a global priority. Early intervention services were established to reduce treatment delays but have had limited impact. This systematic review examines barriers and facilitators to seeking access to these services, to identify targets for service level change.
We conducted a systematic review of relevant databases (PsychINFO, MEDLINE, CINAHL, and PsychARTICLES) using pre-defined search terms for and Given the majority of qualitative studies, a thematic synthesis rather than meta-analysis was indicated.
The search yielded 10 studies. Mental health stigma and discrimination predict DUP, compounded by structural barriers which limit the impact of early intervention services on timely access to recommended treatments. Synthesis of the qualitative studies generated three themes: , and Lack of knowledge, absence of supportive relationships (social and professional), and self-stigma constitute significant barriers to seeking access to early intervention services.
This is the first review of the barriers and facilitators to seeking access to early intervention services. The findings highlight public health and secondary care service targets to expedite access to recommended treatments and thereby reduce the DUP.
未治疗的精神病期（DUP）持续是全球的重点。早期干预服务的设立是为了减少治疗延误，但效果有限。本系统评价检查了寻求获得这些服务的障碍和促进因素，以确定服务水平变化的目标。
我们使用预先定义的搜索词，对相关数据库（PsychINFO、MEDLINE、CINAHL 和 PsychARTICLES）进行了系统评价，由于大多数定性研究表明，需要进行主题综合分析而不是 meta 分析。
搜索结果产生了 10 项研究。心理健康污名和歧视预测 DUP，加上结构障碍限制了早期干预服务对及时获得推荐治疗的影响。对定性研究的综合分析产生了三个主题：对精神疾病的误解和恐惧、服务获取的障碍、缺乏知识、缺乏支持性关系（社会和专业）和自我污名是寻求获得早期干预服务的重大障碍。
这是首次对寻求获得早期干预服务的障碍和促进因素进行的评价。研究结果突出了公共卫生和二级保健服务的目标，以加快获得推荐的治疗，从而减少 DUP。
