Are psychosis polygenic risk scores ready for youth mental healthcare? A qualitative interview study of stakeholders’ perspectives

Background: The clinical translation of polygenic risk scores (PRSs) for mental health disorders lags behind physical health applications. The use of mental health PRSs in children and young people (0-25) represents an important yet underexplored area. PRSs for psychosis, including schizophrenia, attract particular interest due to their relatively high predictive power. Research on stakeholder attitudes is important but limited to date, with no qualitative studies yet conducted in the UK. The aim of this study was therefore to address this gap by exploring UK stakeholder views on implementing mental health PRSs, focusing on psychosis and young people.Methods: Semi-structured interviews were conducted with ten professionals in mental healthcare, genetics research, or related policy areas. Participants considered potential use cases, concerns, implementation challenges, and future directions. Interview transcripts were analysed using reflexive thematic analysis. Coding was primarily inductive, followed by a deductive phase to organise themes under three analytic pre-defined domains.Results: The following ten themes were identified. 1. Opportunities and Benefits: (1.1) Supporting early identification and risk awareness; (1.2) Personalising care and understanding after diagnosis. 2. Concerns and Barriers: (2.1) Limitations in current clinical utility; (2.2) Issues of misapplication and misunderstanding; (2.3) Risks of inequity and discrimination; (2.4) Operational barriers; (2.5) Youth-specific concerns. 3. Future Directions: (3.1) Building the evidence base; (3.2) Investing in clinical readiness; (3.3) Transparent governance and meaningful patient involvement.Discussion: Overall, participants balanced cautious optimism with recognition of scientific, systemic, and ethical challenges: they perceived mental health PRSs as having potential to enhance personalised risk assessment and intervention within symptomatic or help-seeking populations, but also identified multiple barriers and concerns. This study advances understanding by shedding light on UK professionals’ views on integrating mental health PRSs, particularly for psychosis and youth, uncovering underexplored applications and potential roles for PRSs within service pathways. It also identifies important gaps in predictive equity, clinical readiness, and youth-specific safeguards. These insights highlight the need for diverse genomic data, workforce development, and collaborative governance to consider the responsible translation of mental health PRSs into practice.