Health Care Professionals’ Perspectives of Early Intervention in Psychosis Services: A Qualitative Study

Rickett, Michelle; Kingstone, Tom; Gupta, Veenu; Shiers, David; French, Paul; Lennox, Belinda; Chew-Graham, Carolyn

Abstract

Aims
An Early Intervention in Psychosis (EIP) service offers treatment in the community to people with a first episode of psychosis. EIP is meant to be given for three years; after this time, those who are well are discharged to their GP, while those with ongoing symptoms and care needs are transferred to a general community mental health team. People can become unwell at this time of change and might benefit from longer treatment with EIP. We also know that some people who are well could possibly have been discharged back to their GP earlier. The EXTEND programme aims to develop a more tailored approach to EIP services based on the needs of each individual and understand the health, social, and cost-benefits of this approach.

Methods
This qualitative study sits within a larger programme of work. Ethics and HRA approvals gained. Semi-structured interviews were conducted with health care professionals from primary and specialist care, managers and commissioners, to understand why and how decisions about duration of EIP care are made. Interviews have been transcribed and thematic analysis using principles of constant comparison is being conducted. Patient and public involvement is key to all stages of the study.

Results
Five interviews with General Practitioners and twelve interviews with EIP healthcare professionals, managers and commissioners have been conducted. Initial analysis suggests that access to EIP services can be challenging. Initial engagement is needed before therapy can begin. Decisions about duration of care can depend upon availability of access to Community Mental Health teams. Discharge planning rarely involves communication between primary and specialist care, and this can be a difficult transition, particularly when discharge is back to primary care. The pathway back into mental health care following discharge can be difficult. Trusting relationships between service users and EIP professionals are key to the success of EIP care. Healthcare professionals would value - and in some cases are given - flexibility to extend EIP care beyond 3 years.

We have developed a model to illustrate the patient journey through the EIP service which will be presented for the first time at the conference.

Conclusion
This research provides a framework to understand decision-making around duration of care, discharge planning and practices, and post-discharge support for EIP service users. The next phase of the study will be interviews with service users and carers to explore their experiences of EIP services, duration of care and discharge planning.

Citation

Rickett, M., Kingstone, T., Gupta, V., Shiers, D., French, P., Lennox, B., & Chew-Graham, C. (2023, July). Health Care Professionals’ Perspectives of Early Intervention in Psychosis Services: A Qualitative Study. Poster presented at RCPsych International Congress 2023, Liverpool, England, UK

• Presentation Conference Type: Poster
• Conference Name: RCPsych International Congress 2023
• Conference Location: Liverpool, England, UK
• Start Date: Jul 10, 2023
• End Date: Jul 13, 2023
• Deposit Date: Jan 24, 2024
• Publisher: Cambridge University Press
• DOI: https://doi.org/10.1192/bjo.2023.230
• Keywords: Psychiatry and Mental health
• Additional Information: Copyright: Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists; License: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. This does not need to be placed under each abstract, just each page is fine.; Free to read: This content has been made available to all.