Fig. 2.

Illustration of hypothetical recruitment processes and, relatedly, risk enrichment of pretest risk of psychosis in clinical high-risk (CHR) samples, adapted from.⁴⁴ In the general population, mental problems, mainly anxiousness, depressiveness⁴⁵ and family/partner problems,³⁸ and/or worries about one’s mental state may lead to help-seeking. Thereby, outreach campaigns targeting the general population might lead to seeking help directly at high-risk services (self-referrals) but might also unspecifically increase symptom awareness and, relatedly, worries about one’s mental state and help-seeking, thus potentially resulting in a risk dilution. Outreach campaigns targeting (mental) health providers may lead to selective referrals from these sources suspected to possibly suffer from a CHR state; thereby pretest risk enrichment will likely be highest in referrals from mental health professionals.¹⁷