Stigma and treatment delay in first-episode psychosis: a grounded theory study
Version of Record online: 25 JAN 2010
© 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd
Early Intervention in Psychiatry
Volume 4, Issue 1, pages 47–56, February 2010
How to Cite
Franz, L., Carter, T., Leiner, A. S., Bergner, E., Thompson, N. J. and Compton, M. T. (2010), Stigma and treatment delay in first-episode psychosis: a grounded theory study. Early Intervention in Psychiatry, 4: 47–56. doi: 10.1111/j.1751-7893.2009.00155.x
- Issue online: 28 JAN 2010
- Version of Record online: 25 JAN 2010
- Received 1 June 2009; accepted 9 September 2009
- duration of untreated psychosis;
- first-episode psychosis;
Aim: A longer duration of untreated psychosis (DUP) is associated with greater morbidity in the early course of schizophrenia. This formative, hypothesis-generating study explored the effects of stigma, as perceived by family members, on DUP.
Methods: Qualitative interviews were conducted with 12 African American family members directly involved in treatment initiation for a relative with first-episode psychosis. Data analysis relied on a grounded theory approach. A testable model informed by constructs of Link's modified labelling theory was developed.
Results: Four main themes were identified, including: (i) society's beliefs about mental illnesses; (ii) families' beliefs about mental illnesses; (iii) fear of the label of a mental illness; and (iv) a raised threshold for the initiation of treatment. A grounded theory model was developed as a schematic representation of the themes and subthemes uncovered in the family members' narratives.
Conclusions: The findings suggest that due to fear of the official label of a mental illness, certain coping mechanisms may be adopted by families, which may result in a raised threshold for treatment initiation, and ultimately treatment delay. If the relationships within the grounded theory model are confirmed by further qualitative and quantitative research, public educational programs could be developed with the aim of reducing this threshold, ultimately decreasing DUP.