A conceptual model of mental health service utilization among young adults at clinical high-risk for developing psychosis

Shelly Ben-David, Andrea R. Cole, Gary Brucato, Ragy Girgis, Michelle R. Munson

Research output: Contribution to journalArticle


Objective: Research has shown that young adults at clinical high risk (CHR) for developing psychosis have difficulties seeking, accessing, and staying engaged with mental health services. The present study explored perspectives on engagement with mental health services among young adults at CHR. Method: In-depth interviews were conducted with 30 participants at CHR, ages 18-30, from an Eastern U.S. state. Grounded theory methodology was used to analyzed qualitative data. Results: Six major categories emerged from the data reflecting participants' perspectives of engagement with services. Contextual factors such as social, community, and online networks mattered to young adults, and individual factors such as level of awareness, stigma, emotions, and environmental factors emerged as critical. These factors suggested a conceptual model of service utilization among young adults at clinical high risk for developing psychosis that builds upon and extends existing conceptual frameworks of service use among young adults. Conclusion and Implications for Practice: A conceptual model of service utilization among young adults at CHR emerged from that data that can inform interventions aimed at improving engagement in services and reduce the amount of time young adults at CHR remain untreated for emerging psychological problems. Furthermore, this study highlights the unique contribution of mental health service use messages received from online networks and a possible relationship between hierarchical stigma and service use.

Original languageEnglish (US)
Pages (from-to)17-25
Number of pages9
JournalPsychiatric Rehabilitation Journal
Issue number1
StatePublished - Mar 2019



  • Clinical high-risk
  • Early psychosis
  • Mental health service utilization
  • Psychosis risk
  • Young adult

ASJC Scopus subject areas

  • Health Professions (miscellaneous)
  • Rehabilitation
  • Psychiatry and Mental health

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