Turning Points in the Shadows: Critical Incidents Influencing Help-Seeking Behaviours and Duration of Untreated Psychosis in Individuals With Schizophrenia

The extended duration of untreated psychosis (DUP) in individuals with schizophrenia represents a significant challenge in mental healthcare delivery, potentially compromising treatment outcomes and recovery trajectories. Understanding the critical incidents that influence help-seeking behaviours remains crucial yet understudied from patients' perspectives.

To identify and analyse the critical incidents that influence help-seeking behaviours and duration of untreated psychosis in individuals with schizophrenia, and to examine the factors associated with these turning points.

In a qualitative study, 21 individuals in remission from schizophrenia participated in semi-structured interviews based on the critical incident technique. The COREQ guidelines were followed for reporting qualitative research. Interviews were analysed using reflexive thematic analysis to identify key themes and patterns.

Analysis revealed two primary domains: internal turning points (self-recognition of symptoms, personal coping strategies) and external catalysts (family intervention, crisis events). Family members emerged as crucial facilitators in the help-seeking process, with their involvement significantly reducing DUP. Educational background, cultural beliefs, and previous mental health awareness were identified as key factors influencing the timing of help-seeking behaviours.

These findings illuminate the complex interplay between personal, familial and social factors in determining when and how individuals with schizophrenia seek professional help. The results emphasise the critical role of family support systems in facilitating earlier intervention.

Mental health professionals can utilise these insights to develop targeted early intervention strategies and family education programs, potentially reducing DUP and improving treatment outcomes for individuals experiencing first-episode psychosis.