Service user perspectives of an early intervention in psychosis service: a service evaluation
| Published date | 10 September 2018 |
| Pages | 156-164 |
| Date | 10 September 2018 |
| DOI | https://doi.org/10.1108/MHRJ-09-2017-0037 |
| Author | Simon Watkins,Chris Sanderson,Victoria Richards |
| Subject Matter | Health & social care,Mental health |
Service user perspectives of an early
intervention in psychosis service: a
service evaluation
Simon Watkins, Chris Sanderson and Victoria Richards
Abstract
Purpose –The purpose of this paper is to gather the perspectives of individuals accessing an early
intervention in psychosis service (EIPS), in order to inform service development.
Design/methodology/approach –Individual interviews (n ¼9) and one focus group (n ¼7) were
conducted. Discussions focused on open questions pertaining to service users’(SU’s) experiences of
accessing the EIPS. The results were analysed using inductive thematic analysis.
Findings –Inductive thematic analysis was used and three main themes were generated: consistency and
communication, facilitating therapeutic relationships between EIPS staff and SU’s; pushing boundaries,
relating to the importance of services taking a graded approach to developing therapeutic relationships and
(re)engaging in activities; and normalising and validating experiences of psychosis. Participants emphasised
the importance of relationships with EIPS staff and fellow SUs and highlighted how SUs can feel fearful
and vulnerable when staff are not accessible or they view their care as inconsistent. Participants further
emphasised the need for practitioners to balance an approach that de-stigmatises psychotic experiences
whilst validating distress.
Practical implications –Consistency of support from EIPSs can be as important as flexibility. Clinicians
should carefully consider the balance between validating and normalising distressing experiences associated
with psychosis. Offering social activities with other SUs can facilitate therapeutic relationships and recovery
but the results suggest that this should be facilitated in a graded way.
Originality/value –The paper addresses current need in the literature to understand the experiences of
people using services in order to improve the quality of the services provided.
Keywords Early intervention services, Peer support, Service user perspectives,
First episode of psychosis, Normalising
Paper type Research paper
Introduction
Early intervention in psychosis services (EIPSs) are specialist multi-disciplinary community mental
health teams, recommended for people who experience a first episode of psychosis
(Department of Health, 1999; NICE, 2014). These services were introduced in the UK following
research highlighting carer and service user (SU) dissatisfaction with mental health services, but
also the association between the duration of untreated psychosis and poorer prognosis
(Tanskanen et al., 2011; Lester et al., 2012). Individuals experiencing a first episode of psychosis
can face barriers in obtaining prompt access to services. This has included worry about the
stigma associated with mental illness, resulting in help often not being sought until crisis point
(Tanskanen et al., 2011).
In comparison to community mental health teams, EIPSs often have smaller caseloads allowing
for a more assertive and flexible approach. EIPSs offer a youth friendly service delivery, with a
focus on social inclusion and therapeutic optimism (The British Psychological Society, 2005;
Jones et al., 2010). SUs within EIPSs are more likely to have fewer inpatient admissions, use
medication for shorter periods and have an improved prognosis and an increased chance of
Received 1 September 2017
Revised 26 March 2018
Accepted 17 April 2018
Simon Watkins is Clinical
Psychologist at North
Lincolnshire Child and
Adolescent Mental Health
Services, Scunthorpe, UK.
Chris Sanderson is Clinical
Psychologist at Humber NHS
Teaching Foundation Trust,
Hull, UK; and the Faculty of
Health Sciences, Hull
University, Hull, UK.
Victoria Richards is Assistant
Psychologist at Humber NHS
Teaching Foundation Trust,
Hull, UK.
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VOL. 23 NO. 3 2018, pp. 156-164, © Emerald Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-09-2017-0037
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