TY - JOUR
T1 - Stigma of Treatment Stages for First-Episode Psychosis
T2 - A Conceptual Framework for Early Intervention Services
AU - Yang, Lawrence H.
AU - Blasco, Drew
AU - Lieff, Sarah A.
AU - Le, Phuong Thao D.
AU - Li, Yi Ping
AU - Broeker, Marianne
AU - Mascayano, Franco
AU - Bello, Iruma
AU - Nossel, Ilana
AU - Dixon, Lisa
N1 - Publisher Copyright:
© 2021 Lippincott Williams & Wilkins.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Early intervention services (EIS; in the United States, Coordinated Specialty Care) can lead to substantial improvements in psychiatric symptoms and social functioning for individuals with first-episode psychosis who engage in treatment. Nevertheless, stigma associated with early intervention services can limit their full potential benefits by preventing or reducing participation. Drawing from Corrigan's "why try"model positing relationships between public and self-stigma, engagement in treatment services, and the EIS treatment model, this article proposes a framework that delineates how distinct forms of stigma are linked to given stages of treatment engagement in first-episode psychosis. We identify three phases of engagement: (1) community outreach, which has associations with public stigma; (2) the referral and evaluation process, which primarily has associations with self-stigma; and (3) EIS, which have associations with self-stigma and its psychosocial consequences. For each phase, we describe evidence-based strategies typically provided by EIS programs, using OnTrackNY as an exemplary model, to illustrate potential linkages in our conceptual framework. By specifying how distinct forms of stigma are associated with EIS treatment stages, this framework is intended to guide EIS programs in explicitly addressing stigma to optimize recovery of individuals with first-episode psychosis.
AB - Early intervention services (EIS; in the United States, Coordinated Specialty Care) can lead to substantial improvements in psychiatric symptoms and social functioning for individuals with first-episode psychosis who engage in treatment. Nevertheless, stigma associated with early intervention services can limit their full potential benefits by preventing or reducing participation. Drawing from Corrigan's "why try"model positing relationships between public and self-stigma, engagement in treatment services, and the EIS treatment model, this article proposes a framework that delineates how distinct forms of stigma are linked to given stages of treatment engagement in first-episode psychosis. We identify three phases of engagement: (1) community outreach, which has associations with public stigma; (2) the referral and evaluation process, which primarily has associations with self-stigma; and (3) EIS, which have associations with self-stigma and its psychosocial consequences. For each phase, we describe evidence-based strategies typically provided by EIS programs, using OnTrackNY as an exemplary model, to illustrate potential linkages in our conceptual framework. By specifying how distinct forms of stigma are associated with EIS treatment stages, this framework is intended to guide EIS programs in explicitly addressing stigma to optimize recovery of individuals with first-episode psychosis.
KW - Coordinated Specialty Care
KW - OnTrackNY
KW - early intervention
KW - early psychosis
KW - first-episode psychosis
KW - stigma
UR - http://www.scopus.com/inward/record.url?scp=85102705417&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85102705417&partnerID=8YFLogxK
U2 - 10.1097/HRP.0000000000000288
DO - 10.1097/HRP.0000000000000288
M3 - Article
C2 - 33666396
AN - SCOPUS:85102705417
SN - 1067-3229
VL - 29
SP - 131
EP - 141
JO - Harvard Review of Psychiatry
JF - Harvard Review of Psychiatry
IS - 2
ER -