Duration of untreated psychosis (DUP) is a common metric for evaluating early psychosis intervention, with shorter DUP linked to improved outcomes. A prior study with the Early Psychosis Intervention Clinic—New Orleans (EPIC-NOLA) found that patients who accessed care after their first help-seeking episode (“EPIC-First”) had shorter DUP and lower risk of future hospitalization than those with multiple episodes. However, focusing solely on DUP and hospitalization may obscure aversive experiences within the help-seeking journey. To further characterize the EPIC-First subgroup and analyze patient-reported barriers to care through thematic analysis. All participants who completed the pathways to care (PTC) assessment between November 2018 and July 2024 were included. The PTC captures both structured and narrative data on help-seeking episodes (HSEs). We described demographic and clinical features of EPIC-First patients and analyzed narrative responses from all participants to identify common barriers. Of 79 participants, 32 were EPIC-First. Mean DUP was 18 weeks (median 30, IQR 8–51), below the national average of 74 weeks. Most (n = 26) entered care through hospitalization, with 14 voluntary admissions. Distress was the most reported motivator for seeking help (75%). Thematic analysis revealed three barriers: stigma, limited awareness of symptoms or services, and unhelpful provider responses. Reducing DUP must be paired with strategies to promote more supportive, non-coercive access. HSEs offer insight into how interpersonal and structural factors shape care trajectories.
Guillory et al. (Sun,) studied this question.