Journeys from Early Intervention in Psychosis services to primary care: a case study approach.

Abstract

Early Intervention in Psychosis (EIP) services offer up to 3 years' treatment in the community to people who have experienced a first episode of psychosis. Service users (SUs) are then discharged to primary care (the majority) or community mental health teams. There is limited research on SU experiences of discharge from EIP to primary care and the roles of care providers through this transition. Longitudinal, case study approach. Ethics and HRA approvals gained. Semi-structured interviews with SUs shortly after EIP discharge (x16); follow up interviews after 6-11 months (x12). Care providers interviewed with SU consent (x14). 8 SUs formed into case studies - interviews with 1-3 care providers for each.Thematic analysis conducted using principles of constant comparison within and across cases. Patient and public involvement throughout, including contributing to data analysis. SUs discharged to primary care report little to no support in the early post-discharge period and can be reluctant to approach primary care due to lack of relationships and trust.Care providers highlight gaps in communication across SU support networks.We were unable to recruit GPs to the case studies, which may reflect their lack of relationship with EIP SUs. Family carers can play a 'case manager' role, but do not always feel listened to. This study highlights the need for improved collaboration between SUs, carers and healthcare practitioners through transition from EIP. We suggest that there should be a joint consultation between SU, carer, EIP care coordinator and GP at point of discharge.