An exploration of what service users value about early intervention in psychosis services.

Abstract

Given the potential severity of developing chronic mental health problems, particular attention has been paid to the first emergence of psychosis. Earlier detection is expected to lead to quicker access to the effective treatment that is necessary during the 'critical period' and is one of the main incentives for setting up early intervention in psychosis (EIP) services. EIP services have demonstrated good clinical outcomes since inception, but little is understood yet as to which specific element of EIP leads to these good outcomes. The aim of this research was to conduct an exploratory investigation of the elements that people experiencing a first episode of psychosis find most valuable about EIP treatment. The study employed a single group design and utilized Q-methodology. 20 people with first-episode psychosis aged between 18 and 35 were recruited and asked what they valued most about EIP. Four separate factors were identified, which were interpreted and named as 'therapeutic relationship', 'medical care', 'psychological interventions', and 'support, coping and recovery'. Three of the factors were consistent with a biopsychosocial approach of EIP that is recommended by expert professionals working in EIP services and Government guidance on service delivery. The factor that accounted for the most variance is 'therapeutic relationship', highlighting the importance of non-specific factors in mental health care and recovery from a first episode of psychosis. Service users reported that four main components of Early Intervention in Psychosis Services were helpful to them. These included a strong and effective therapeutic relationship, as well as medication, psychological therapies, and practical help and support. Services are valued both for the quality of the therapeutic relationship but also for their ability to deliver meaningful and valued treatments in this context.