'At the end of my string': The experience of parents caring for a young person with emergent psychosis

Introduction: Rural parents struggle to find appropriate pathways to help a son with emergent psychosis. An early presentation of psychosis is often described as 'something not quite right', and may be interpreted by parents, as a difficult phase in adolescent developmental. As such, it may be thought of as if to pass with time. It is not always an obvious conclusion to seek mental health care. The findings of this study reveal some factors which impact access to early treatment for young rural men. Methods: A qualitative study using interpretive phenomenological methods was conducted in rural northern NSW. Young men and parents participated in in-depth interviews which were transcribed and thematically analysed. Results: One theme, which emerged, was that parents struggle to identify sources of help. Parents did not always see health professionals as a first line of help provision. Another theme developed around the unpredictability and social discomforts that occur in family life as mental illness emerges. A burden of care was felt by parents who had hoped that their son would have achieved their own independence by this time. This type of family stressor was a significant trigger in developing new ad hoc coping strategies within the family and for the family to commence some in-house strategies in their quest for getting past this disruptive phase in family life. Discussion: The findings suggest that the participants had difficulty identifying appropriate pathways to access help, and that they have developed their own ways of helping within the internal structure of family. This may explain why some rural young men experience a lengthy duration of untreated psychosis. Further, that the burden of care which parents experience during their son's emergent phase of illness, creates a substantial burden on the emotional and social integrity of the family, and that this burden causes some parents to question how long they can cope, before they reach 'the end of their strings'.