Barriers and Facilitators to Accessing Primary Care in Patients With First-Episode Psychosis

Objective: Patients with psychotic disorders have higher rates of medical comorbidities and premature mortality compared to the general population but have been shown to access primary care at low rates. Young adults are at risk of disengaging from primary care services during the transition to adulthood. This descriptive qualitative research study sought to explore barriers and facilitators to engaging with primary care among young adults with first-episode psychosis (FEP).

Methods: Ten patients aged 18-30 years receiving care in a coordinated specialty care clinic for FEP were recruited from October 2021 to December 2022. Participants were interviewed using a semistructured interview guide. Interviews were recorded and transcribed. A codebook was created inductively using data from the transcripts, and themes were generated from group consensus.

Results: Two themes relating to access to primary care were identified: (1) barriers, which included scheduling conflicts and missed appointments, active mental illness symptoms, and difficulties in rapport with the primary care physician (PCP) and (2) facilitators, which included proximity to home, absence of financial barriers, availability of urgent appointments, and caring, nonjudgmental attitudes of the PCP.

Conclusion: Improving engagement in primary care is critical for young adults with FEP to establish beneficial patterns of health care use and timely access to preventative care. This study identifies factors that may help facilitate care with PCPs, which could increase timely utilization of medical care and reduce premature mortality within this vulnerable population.

Prim Care Companion CNS Disord 2025;27(5):25m03974.

Author affiliations are listed at the end of this article.