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Aim: Access to timely treatment is key to early intervention in psychosis. Despite this, barriers to treatment exist. In this review, we aimed to understand the structural barriers that patients and caregivers face in help‐seeking for first‐episode psychosis, and the recommendations provided to address these. Methods: We conducted a systematic review (PROSPERO: CRD42021274609) of qualitative studies reporting structural barriers to help‐seeking from the patient or caregiver perspective. Searches were performed in September 2023, restricted to studies published from 2001. Study quality was appraised using Critical Appraisal Skills Programme. Data were analysed using thematic synthesis. Results: Nineteen papers from 11 countries were included. Across all papers, participants reported experiencing structural barriers to receiving healthcare. For many patients and caregivers, the process of accessing healthcare is complex. Access requires knowledge and resources from parents, caregivers and healthcare providers, yet too often there is a misalignment between patients' needs and service resources. Expertise amongst healthcare providers vary and some patients and caregivers experience negative encounters in healthcare. Patients highlighted earlier caregiver involvement and greater peer support as potential routes for improvement. Conclusion: Patients and caregivers face multiple structural barriers, with legislative practices that discourage family involvement, and healthcare and transport costs found to be particularly problematic. Understanding these barriers can facilitate the co‐design of both new and existing services to provide easier access for patients and caregivers. Further research is needed focusing not only on the perspectives of patients and caregivers who have accessed professional help but also crucially on those who have not. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to synthesise the psychosocial stressors of siblings of people with experiences of psychosis (SOPEP). Understanding the specific needs of siblings across diverse cultures would help mental health services to provide culturally specific psychosocial family and sibling‐centred support. This may result in improved relationships between families, better psychosocial well‐being for siblings and better outcomes for patients. Methods: Following PRISMA guidelines, a systematic review was conducted to explore the psychosocial stressors of SOPEP. Six databases were utilised to identify literature using qualitative methodology. Results: Twenty‐two studies were included that investigated the Psychosocial Stressors of SOPEP. SOPEP's experiences were influenced by various stages: individual factors, social factors, physical and macro‐level environments. Six key components contributed to SOPEP's psychosocial stressors and facilitated or hindered their intentions, behaviours and experiences of caregiving. These were the SOPEP's beliefs about psychosis, caregiving beliefs, family and cultural values, personality traits, pragmatic challenges and access to resources. Conclusions: Globally, SOPEP and families may benefit from their involvement in family interventions and individual support that facilitates caregiving and acknowledges their responsibilities, resources, psychosocial needs and emotional experiences. [ABSTRACT FROM AUTHOR]