Using quality improvement methods to improve the effectiveness and sustainability of a social skills intervention for public mental health consumers with psychosis

Abstract

ABSTRACT Objective While research has shown that psychosocial intervention can improve loneliness and social isolation for adults with psychosis, they are often not routinely offered. This study aimed to learn from consumers to refine a social skill and friendship group (termed “Rel8”) by using Plan-Do-Study-Act (PDSA) quality improvement methodology. This methodology was used to examine the impact of PDSA on intervention implementation and consumer engagement. Methods Mixed-methods were used to compare how engagement, attendance and consumer experience of care changed with two Rel8 groups prior to vs two groups after PDSA-informed changes to content (to address social anxiety and translation of learning) and establishment of a lead therapist. Results Thirty-one consumers commenced Rel8, but completion rates were significantly higher after (83%) than before (42%) PDSA-informed changes to Rel8. Participants found both groups were effective in improving social skills. Conclusion People with psychosis in community mental health services want and benefit from intervention to build social connections. Quality improvement methods that respond to consumers’ feedback and experiences can support programmes to evolve and better meet consumer needs. KEY POINTS What is already known about this topic: People with psychosis want and benefit from psychosocial interventions but these interventions are not routinely offered. Rel8 is an effective, locally adapted program for improving social skills in those with psychosis. Quality improvement processes can be used to enhance implementation, sustainability and the scaling up of evidence-based psychosocial interventions in many healthcare settings.What this topic adds: Incorporating consumer feedback into the implementation and refinement of treatment programs can maximise engagement. Even in resource constrained public mental health settings, quality improvement processes can be used to improve the way evidence-based treatments are designed and delivered. Evidence based social skills focused group interventions are more effective when integrated into the overall care provided, rather than being seen as a stand-alone intervention.