Identifying Barriers and Pathways to Care Among College Students at Risk of or Diagnosed with First Episode Psychosis

Prolonged untreated psychosis worsens outcomes, thus motivating the study of pathways and perceived barriers to care, especially for high-risk age groups like college students. The primary objective of this study was to explore pathways to coordinated specialty care (CSC) and perceived barriers to care in college students at high risk for psychosis or with first-episode psychosis and determine any association between them. Twenty-four college students enrolled in CSC completed the Circumstances of Onset and Relapse Schedule and Barriers to Seeking Psychological Help Scale (BSPHS). Non-parametric tests were used for two-group analyses, and medians and interquartile ranges (IQR) were calculated. The median number of total contacts along the pathway to CSC was 5.0 (IQR = 5.2), with more psychiatric contacts (Mdn. = 3.0, IQR = 2.2) than non-psychiatric contacts (Mdn. = 2.0, IQR = 3.0). Students whose first contact was with non-psychiatric services had longer pathways to care overall, with a higher median number of total psychiatric as well as non-psychiatric contacts relative to students whose first contact was with psychiatric services. With the highest possible total BSPHS score being 5, the median score was 2.7 (IQR = 0.8). Targeted psychosis literacy training for non-mental health professionals and anti-stigma campaigns for college students may help reduce the duration of untreated psychosis.