Barriers to early identification of early psychosis among young rural males

Rhonda L Wilson, Clinical Nurse Specialist

Early Psychosis Project, Hunter New England Health – Northern RegionMasters Nursing Honours Candidate – University of New England02 6776 9827 or 0428 618 680 or RhondaL.Wilson@hnehealth.nsw.gov.auAcknowledgements: NSW Institute of Rural Clinical Services and Teaching Rural Research Capacity Building Program

Prevalence of EP in Northern New South Wales is increasing. During 2005 there were 76 recorded cases of EP within an identified

population of young people in this geographical region.

Identifying EP prodrome (early signs) in rural communities is not easy. Small rural communities are separated from neighbouring larger

communities by significant physical distances, while often containing few resident health care professionals (HCPs), and fewer specialist youth mental health professionals. The opportunity for young people with emerging EP to be identified is correspondingly limited. Social proximity in small communities may sometimes be a disincentive for young people from seeking mental health care due to concerns with stigma and reputation. In addition, young people increasingly ‘hang out’ in cyberspace rather then in-person. HCPs may need to modify practice, accommodating youth culture and communication styles.

This study comes at a time when health services across Australia are exploring opportunities to improve the delivery of mental health

services to young people. Rural communities have specific dynamics which need to be considered in developing suitable service delivery models. This research explores the barriers to early identification and early intervention of early psychosis (EP) in rural communities, and

informs models of service delivery, reverberating with young men, their rural culture and place.

The current qualitative interpretative phenomenological analysis study explores the experiences of young rural men aged between 18

& 24 years. This group is over represented in rural EP morbidity profiles. Study findings will usefully inform mental health service delivery model development for this group. Study methods include in-depth interviewing (snowballing and purposive selection), with thematic coding and analysis. Study participants selected are residents of rural communities in Northern inland New South Wales.

The length of duration of untreated psychosis adversely effects the long term prognosis and recovery period. Discovering the barriers

to early identification of EP amongst young rural men is important information to better achieve a reduction in the length of untreated psychosis, and thereby improve prognoses for this group.

Finding the young men, and identifying the barriers to accessing mental health services for them, is a challenge. The literature

suggests that this group of young men are less likely to be current mental health service clients, less likely to be in training, employment, or organised sports/arts activities, and more likely to be increasingly isolating socially as psychosis and adverse symptoms emerge.