Understanding the Role of the Family Physician in Early Psychosis Intervention: A Mixed Methods Study

Psychotic disorders have a profound impact on the lives of young people. The symptoms of psychosis may include delusions, hallucinations, and erratic or unusual behavior. The onset of these symptoms usually occurs in adolescence and young adulthood. This has a big impact on a person’s social, educational, and career development. People with psychosis have better outcomes if we identify and treat them soon after symptoms begin. But Canadian research shows that many people with first-episode psychosis have difficulties accessing specialized treatment programs, and some people receive ongoing mental health care from their family doctor.

This project used data from electronic medical records of family doctors, as well as interviews with young people with first-episode psychosis, family doctors, and clinicians at specialized programs. Our aim was to understand whether people sought help from their family doctor for the early symptoms of psychosis. We looked at how many cases of early psychosis are detected in primary care, and how the family doctor manages these patients. We also examined whether some groups, such as immigrants or those living in rural areas, sought care more or less often from their family doctor.

The findings from this project provide an in-depth description of first-episode psychosis in primary care and the challenges associated with its recognition and management. This will inform strategies to build linkages between primary care and psychiatric services to improve transitions of care during the crucial early stages of psychosis and after specialized treatment is completed. Our findings highlight opportunities for increasing collaboration between primary care physicians and psychiatrists and other clinicians working in early psychosis intervention. Improving supports for primary care physicians in their crucial role in early intervention for psychosis will enhance the quality of care for early psychosis to improve long-term outcomes.

Project participants

Funding: Canadian Institutes of Health Research – Project Grant; Ontario Ministry of Research, Innovation, and Science – Early Researcher Award

Principal Investigator: Kelly Anderson

Co-Investigators: Suzanne Archie, Richard Booth, Chiachen Chang, Saadia Hameed, Liisa Jaakkimainen, Paul Kurdyak, Dan Lizotte, Arlene MacDougall, Ross Norman, Lena Palaniyappan, Bridget Ryan, Amanda Terry, Aristotle Voineskos

Staff: Rebecca Rodrigues

Students: Brooke Carter, Jordan Edwards, Myanca Rodrigues, Nicole Schoer, Joshua Wiener