Conditional Disclosure on Pathways to Care: Coping Preferences of Young People at Risk of Psychosis

Qual Health Res. 2017 Oct;27(12):1842-1855. doi: 10.1177/1049732316680337. Epub 2016 Dec 5.

Abstract

The interrelationship between stigma and help-seeking is under-researched among children and adolescents. This study explored stigma in relation to pathways to care among young people putatively in an early stage of increased risk of developing psychotic disorders. "Pathways to care" was defined as help-seeking and support from informal and formal resources, and increased risk was determined through the presence of persistent psychotic-like experiences and internalizing/externalizing psychopathology. Twenty-nine qualitative interviews were analyzed using thematic analysis. We defined the superordinate theme in these data as "conditional disclosure," a concept reflecting the rules and prerequisites that influenced how/whether participants sought help. Through parallels between these findings and established stigma theory, we examined how these conditions could be interpreted as influenced by stigma. Our findings demonstrate the influence of stigma on young people's perceptions of a range of pre-clinical symptoms, and on how they seek support for these symptoms.

Keywords: Western Europe, Britain; adolescents, youth, young adults, at risk; adolescents, youth, young adults, mental health and illness; children, illness and disease; community and public health; confidentiality, privacy, disclosure; health care, access to; health, health promotion; illness and disease; prevention; psychology, psychological issues; qualitative; research strategies, interviews; research strategies, thematic analysis; social support; stigma.

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Critical Pathways*
  • Female
  • Focus Groups
  • Humans
  • Interviews as Topic
  • Patient Preference / psychology*
  • Psychotic Disorders / psychology
  • Psychotic Disorders / therapy*
  • Risk Factors
  • Self Disclosure*
  • Young Adult