The Family Physician and Pathways to care

• Timely and adequate management of first-episode psychosis is associated with better clinical and functional outcomes.

• Family physicians are an important access point for psychiatric care. For young people seeking help in primary care for early signs and symptoms of psychosis, there is an opportunity for earlier detection and intervention.

Study Objectives

• To understand the role of the family physician and primary care services in the help-seeking, recognition, and ongoing management of young people with first episode psychosis.

Methods

• We are using health administrative data housed at ICES to examine trends in help-seeking, recognition and diagnosis, and management of first-episode psychosis in primary care across Ontario.

• We are using a survey of family physicians to understand the knowledge, attitudes, preferences, and needs of family physicians in Ontario, in regards to early psychosis.

• We are conducting qualitative interviews with family physicians, people with first-episode psychosis, caregivers, and early psychosis intervention staff to provide further insight into the trends observed in health administrative data.

Results to Date

In the year prior to psychosis onset, people with psychosis are more likely to have access to a regular family physician compared to age-, sex-, and neighbourhood matched controls.

In the 6 years before psychosis onset, people with psychosis visit primary care more than twice as often as matched controls, for mental, physical, and preventative health reasons.

In the 6 months prior to first diagnosis of psychosis, 3 in 5 people will seek help in primary care for a mental health reason.

Among young people seeking help in primary care prior to psychosis onset, 59% receive their first diagnosis of psychosis in primary care.

Study Impact and Contributions

Our findings will provide information for:

• The development of interventions aimed at better supporting family physicians in their central role in pathways to care for first-episode psychosis.

• Improvement of collaboration and continuity of care for young people with first-episode psychosis.