A qualitative analysis of the factors that influence engagement according to people diagnosed with a first episode psychosis 20 year ago

Poster A93, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron

Donal O'Keeffe1,2, Ann Sheridan3, Aine Kelly4, Roisin Doyle1, Kevin Madigan5, Elizabeth Lawlor1, Mary Clarke1,6; 1Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland, 2School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland, 3School of Nursing Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland., 4Research Department, Saint John of God Hospitaller Ministries, Stillorgan, Co. Dublin, Ireland, 5Saint John of God Community Mental Health Services Limited, Co. Dublin, Ireland, 6School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland

Purpose: Mental health services are only effective if service users engage with the interventions they provide. Approximately one-third of people with serious mental illnesses who have had contact with a mental health service disengage from care. Few studies have explored what service users report as influencing their engagement with interventions over the long term. Research into engagement among people diagnosed with a ‘psychotic illness’ is vital, as data indicates disengagement is particularly common among this group. Materials and Methods: Participants were purposefully sampled from the Dublin First Episode Psychosis Cohort which comprises 171 individuals who were diagnosed with a First Episode Psychosis between 1995 and 1999. Semi-structured 45-90 min interviews were conducted using an interview guide. Interviews focused on the factors that support and hinder engagement with treatment. Interviews were audiotaped and transcribed. Data was analysed using Thematic Network Analysis. Basic, organising, and global themes were identified. Results: Findings provide insight into what supports and hinders treatment engagement from the perspectives of service users. To enhance engagement, services could consider promoting: shared decision making; patient centred communication; empowerment; and positive risk taking. Conclusion: Themes identified have implications for mental health services seeking to enhance engagement. Having multiple entry points to a service, widely disseminating service information to the general public, and designing services to target those who are marginalised and isolated may be of benefit. Removing unnecessarily bureaucratic processes, unwelcoming physical environments, complex programme procedures, and inflexible methods of service delivery are also likely to be advantageous.

Topic Area: First Episode Psychosis

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