Title: Improving Engagement in Early Interventions: A pilot study adopting young psychosis service user and carer perspectives to shape EIP Services in the South East for patient benefit
Funder: Department of Health (England)

Abstract: Background Engagement with Early Intervention in Psychosis (EIP) services in the critical 2-3 year period following onset improves patients’ symptoms, illness course, employment and suicide rates in the long term. However, at least 25-30% of patients nationally and in the South East disengage from services within the first 12 months [1-7] with detrimental long term impacts on patient outcome [8]. Improving EIP services is a priority for the South East SHA. This evidence and recommendations from the New Horizons document emphasise the need to develop more effective youth-focused models of intervention that improve engagement. This study aims to close this gap in service provision by developing an intervention focused on the specific needs of those patients who disengage from EIP services. Aims The research question is threefold: i) What are the facilitators and barriers to engagement in EIP services? ii) What changes should be made to services, based on knowledge of engagement issues? iii) Can youth-focussed service adaptations be effectively implemented to improve engagement? To improve engagement by: (i) identifying young people’s and families’ views about facilitators and barriers to engagement. (ii) developing a youth focused model with adaptations including a) the provision and use of information b) approaches to engagement c) the involvement of young people in their services (iii) implementing the intervention in EIP services. Impacts on engagement will be evaluated quantitatively. Stakeholder perceptions of the intervention will be explored qualitatively. Plan of Investigation Phase 1 Regional focus groups with young people, EIP service users and carers will provide novel in-depth data to identify what helps or hinders engagement. A multidisciplinary team will use qualitative analyses to produce draft EIP service adaptations. Phase 2 A consultation (Delphi) process will be conducted with managers, commissioners and clinicians in the South East to turn the draft into a set of pragmatic, deliverable service adaptations. A booklet and website, consultancy and training, will be designed, with service users, to implement the adaptations. Phase 3 The intervention will be implemented as a pilot and the proportion of people who disengage will be compared pre and post intervention. Interviews will explore stakeholders’ perceptions of the adaptations in depth. Potential Impact The youth-focussed shaping of EIP services aims to increase the number of people who engage. Service users and families will benefit from more information and options for engagement to better meet their needs, leading to better outcomes. Clinicians in Sussex will receive user-friendly, pragmatic guidance and tools in the form of training, consultancy, a booklet and a website to help them engage more easily with young people and their families. This will result in more effective and efficient approaches to engagement, fewer failed attempts and more service user and staff satisfaction. The study will pilot the intervention and assess the feasibility of delivery to improve engagement in EIP services. It will report on outcomes and will inform the development of a randomised controlled trial.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;7.3 MANAGEMENT AND DECISION MAKING
Health categories: MENTAL HEALTH