Voices from Within: Saudi Arabian Women's Lived Experiences of First-Episode Psychosis, Hospitalisation, and Recovery Pathways.

Background: While the consumer experience of psychosis has received significant attention in Western research, a substantial gap exists regarding the experiences of women in the Kingdom of Saudi Arabia (KSA). In this context, religious, cultural, familial, and gender-specific factors uniquely shape the experience of psychosis, help-seeking behaviors, and recovery. This study aimed to explore the lived experiences of Saudi women with psychosis across three phases: first-episode onset, hospitalization or follow-up, and community living after discharge. Methods: This hermeneutic phenomenological study, guided by van Manen's methodology, employed all six lifeworld existentials: lived space, lived body, lived time, lived self-other, lived thing, and lived cyborg. Semi-structured interviews were conducted with 21 women diagnosed with psychosis at two hospitals in Riyadh, KSA. Data collection included 13 audio-recorded interviews and eight documented via field notes, supplemented by creative methods such as drawings, poems, and written texts analyzed using van Manen's vocative method. All Arabic data were professionally translated and verified for accuracy. Results: Three overarching themes emerged. First, women's lived experiences of first-episode psychosis highlighted the process of understanding causes and developing insight during onset. Second, experiences during admission and follow-up revealed the impact of clinical encounters, nursing care, and the critical need for therapeutic healing spaces. Third, living with psychosis in the community emphasized the complexities of medication adherence, family dynamics, and the pursuit of recovery through education, employment, and religious practice. Conclusions: The participants articulated user-based recovery perspectives, including empowerment, shared decision-making, and hope, which contrasted sharply with the service-based approaches they received. Culturally specific stressors and pervasive stigma shaped every phase of their journey. To the authors' knowledge, no prior study has examined this population using a hermeneutic phenomenological framework; these findings provide a women-focused, culturally situated evidence base for developing gender-specific recovery models and enhanced discharge planning within the KSA mental health system.