Stigma Associated with a High-Risk State for Psychosis among Adolescents and Young Adults

An episode of a psychotic disorder, the most serious form of mental illness, is a very confusing, frightening, and difficult time for patients and their family. Clinicians and researchers working in the field of psychotic disorders are attempting to intervene early in the course of illness by identifying individuals at high-risk for psychosis (HRP). Intervening in this high-risk group may prevent or delay the onset of psychosis and reduce morbidity and disability from this debilitating disorder. However, there are legitimate concerns regarding the risks associated with intervening in individuals who have not yet developed a diagnosable disorder, especially given that many individuals will not go on to develop the full symptoms of psychosis. One such concern is the high risk of stigma, both from external sources and self-stigma. No studies to date have examined the consequences of identifying individuals at risk on the stigma experiences of young people at a high risk of psychosis. This study will investigate the effects of stigma in this high-risk population, and look at the impact of stigma on the use of mental health services. Specifically, this study will examine the extent to which baseline measures of stigma are associated with patterns of health services use preceding identification as HRP, and the impact of stigma on subsequent engagement with health services. The results will further our understanding of some of the barriers patients face when seeking help for the early symptoms of a psychotic disorder. This information could help health care administrators and policy makers to provide less stigmatizing services, and can help inform interventions aimed at countering the pervasive stigma faced by individuals suffering from mental illness. This is a crucial component of the discourse on HRP to determine whether the benefits gleaned from preventing potential cases of psychotic disorder outweigh the risks of identifying and labelling those at highest risk.