Women's lived experiences of first-episode psychosis care: implications for gender-responsive care

Women with first-episode psychosis (FEP) may experience distinct clinical, reproductive and social challenges, yet their experiences of psychosis care remain underexplored. Greater understanding of women's perspectives is needed to inform gender-responsive service provision.

To explore how women make sense of their experience of psychosis care, to identify areas where gender-specific needs were unmet and to highlight priorities for improving care for women experiencing FEP.

This qualitative study employed semi-structured interviews with women who had experienced FEP and received care through early intervention in psychosis and adult community mental health services (N = 15). Data were analysed using reflexive thematic analysis.

Four overarching themes were identified: (a) violations of personhood and bodily integrity; (b) invisible menstrual and reproductive health in mental healthcare; (c) women-specific barriers to accessing and sustaining care; and (d) moving towards better care for women with FEP. Women described feeling unsafe in mixed-gender in-patient settings, experiencing unmet reproductive and menstrual health needs and navigating caregiving responsibilities that complicated engagement with care. Findings informed a framework of recommendations for improving gender-responsive psychosis care.

This study provides one of the first in-depth qualitative examinations of women's experiences of FEP care. Women described how their experiences were shaped by issues of safety, autonomy, reproductive health and gendered expectations that remain insufficiently recognised within current service models. These findings highlight persistent gaps in sex- and gender-responsive psychosis care, and support the development of services that more effectively address women's safety, reproductive health and caregiving needs.