Crucial Individuals in the Help-Seeking Pathway of Chinese Caregivers of Relatives with Early Psychosis in Hong Kong‪.‬

Studies on the help-seeking pathways of different cultural groups have consistently revealed that Chinese people with mental illness often experience a much longer delay in help seeking than other ethnic groups (Ryder, Bean, & Dion, 2000; Skeate, Jackson, Birchwood, & Jones, 2002), and the duration of untreated psychosis can be as long as one to two years. Although findings have indicated that people with a longer duration of untreated psychosis are likely to be less responsive to treatment and require more long-term intensive intervention (McGorry & Edwards, 2002), a growing body of clinical evidence has revealed that early detection and intervention in young people with schizophrenia may result in a substantial reduction in morbidity and in better quality of life for these people and their families (Black et al., 2001). It has been suggested that recovery from psychosis is greatest at the early stage of the development of the illness (Drake, Haley, Akhtar, & Lewis, 2000). Rogler and Cortes (1993) maintain that the help-seeking process usually involves a network of people, from the intimate and informal confines of the nuclear family, through successfully more select, distant, and authoritative laymen, until the professional is reached. Bhugra and colleagues (1999) argued that the nature and duration of the help-seeking pathways of a particular cultural group are determined by the interaction among three levels of factors: individual level, cultural level, and the social institution. On the individual level, the person's recognition and acceptance of illness and the degree of personal stigma influence his or her readiness to seek help. On the cultural level, factors such as cultural beliefs about mental illness and the influence of the informal network shape the help-seeking pathways of the people involved. Last, "social institution" refers to the perceived availability of, access to, and delivery of health services, such as the availability of ethnic mental health workers. Thus, the extent to which social institution is perceived and is able to provide access for individuals to obtain formal psychiatric services affects individuals' motivation to seek help.