Conceptual and analytic model of Pathway to Care (PTC) with example values.

This figure depicts the pathway to care described by the following narrative (durations are shorter than sample data for illustrative purposes): Peter began experiencing concerning auditory hallucinations on Day 0 (Onset). Two days later, his mother observes him responding to internal stimuli (first community node) and takes him to an urgent care clinic (first clinical node) the same day. They recommend watchful waiting and outpatient follow up. The next day, Peter is more bothered with the hallucinations and makes an appointment for himself (second community node) at an urgent care psychiatric service the next day. On that visit on Day 4 (second clinical node), Peter is prescribed an antipsychotic to help with his symptoms and an appointment is made for an outpatient psychiatrist, whom he sees 3 days later (third clinical node). On Day 8, Peter’s father observes increasingly concerning behaviors (third community node) and takes him to see a youth counselor at their church (fourth community node) who recommends taking him to the local Emergency Department, which they do (fourth clinical node). The ED refers Peter to STEP and he is enrolled the next day, Day 9 (STEP). DUP-total: Duration of Untreated Psychosis. DUP-demand: Demand-side duration of untreated psychosis, number of days from Onset until antipsychotic. DUP-supply: Supply-side duration of untreated psychosis, number of days from antipsychotic until STEP. Onset: Onset of psychosis, as ascertained by POPS criteria on the SIPS scale. STEP: Enrollment in Specialized Treatment Early in Psychosis clinic. Onset delay: Time in days from onset of psychosis first help-seeking node. Marginal-delay: Time in days until the next node.