Layers of listening: qualitative analysis of the impact of early intervention services for first-episode psychosis on carers' experiences

Anna Lavis; Helen Lester; Linda Everard; Nicholas Freemantle; Tim Amos; David Fowler; Jo Hodgekins; Peter Jones; Max Marshall; Vimal Sharma; John Larsen; Paul McCrone; Swaran Singh; Jo Smith; Max Birchwood

doi:10.1192/bjp.bp.114.146415

Layers of listening: qualitative analysis of the impact of early intervention services for first-episode psychosis on carers' experiences

Br J Psychiatry. 2015 Aug;207(2):135-42. doi: 10.1192/bjp.bp.114.146415. Epub 2015 May 21.

Authors

Affiliations

¹ Anna Lavis, MRes, PhD, University of Birmingham, UK; Helen Lester (deceased), MBBCh, MD, previously at the School of Health and Population Sciences, University of Birmingham; Linda Everard, BSc, The Early Intervention Service, Aston, Birmingham; Nicholas Freemantle, PhD, Department of Primary Care and Population Health, UCL Medical School (Royal Free Campus), Rowland Hill; Tim Amos, MBBS, MRCPsych, Academic Unit of Psychiatry, University of Bristol; David Fowler, PhD, University of East Anglia, Norwich; Jo Hodgekins, PhD, DClinPsych, Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich; Peter Jones, MB BS, PhD, Department of Psychiatry, University of Cambridge and CAMEO, Cambridge and Peterborough NHS Foundation Trust; Max Marshall, MB BS, MD, School of Medicine, University of Manchester; Vimal Sharma, MD, FRCPsych, PhD, Faculty of Health and Social Care, University of Chester and Cheshire and Wirral Partnership NHS Foundation Trust; John Larsen, PhD, Evaluation Team, Rethink Mental Illness, London; Paul McCrone, PhD, Centre for the Economics of Mental Health/Section of Community Mental Health, King's College London; Swaran Singh, MBBS, MD, FRCPsych, DM, Health Sciences Research Institute, School of Medicine, University of Warwick; Jo Smith, PhD, Worcestershire EI Service, Worcestershire Health and Care NHS Trust, Worcester; Max Birchwood, PhD, DSc, Mental Health and Wellbeing, University of Warwick, Coventry a.c.lavis@bham.ac.uk.
² Anna Lavis, MRes, PhD, University of Birmingham, UK; Helen Lester (deceased), MBBCh, MD, previously at the School of Health and Population Sciences, University of Birmingham; Linda Everard, BSc, The Early Intervention Service, Aston, Birmingham; Nicholas Freemantle, PhD, Department of Primary Care and Population Health, UCL Medical School (Royal Free Campus), Rowland Hill; Tim Amos, MBBS, MRCPsych, Academic Unit of Psychiatry, University of Bristol; David Fowler, PhD, University of East Anglia, Norwich; Jo Hodgekins, PhD, DClinPsych, Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich; Peter Jones, MB BS, PhD, Department of Psychiatry, University of Cambridge and CAMEO, Cambridge and Peterborough NHS Foundation Trust; Max Marshall, MB BS, MD, School of Medicine, University of Manchester; Vimal Sharma, MD, FRCPsych, PhD, Faculty of Health and Social Care, University of Chester and Cheshire and Wirral Partnership NHS Foundation Trust; John Larsen, PhD, Evaluation Team, Rethink Mental Illness, London; Paul McCrone, PhD, Centre for the Economics of Mental Health/Section of Community Mental Health, King's College London; Swaran Singh, MBBS, MD, FRCPsych, DM, Health Sciences Research Institute, School of Medicine, University of Warwick; Jo Smith, PhD, Worcestershire EI Service, Worcestershire Health and Care NHS Trust, Worcester; Max Birchwood, PhD, DSc, Mental Health and Wellbeing, University of Warwick, Coventry.

PMID: 25999336
DOI: 10.1192/bjp.bp.114.146415

Abstract

Background: Early intervention services (EIS) comprise low-stigma, youth-friendly mental health teams for young people undergoing first-episode psychosis (FEP). Engaging with the family of the young person is central to EIS policy and practice.AimsBy analysing carers' accounts of their daily lives and affective challenges during a relative's FEP against the background of wider research into EIS, this paper explores relationships between carers' experiences and EIS.

Method: Semi-structured longitudinal interviews with 80 carers of young people with FEP treated through English EIS.

Results: Our data suggest that EIS successfully aid carers to support their relatives, particularly through the provision of knowledge about psychosis and medications. However, paradoxical ramifications of these user-focused engagements also emerge; they risk leaving carers' emotions unacknowledged and compounding an existing lack of help-seeking.

Conclusions: By focusing on EIS's engagements with carers, this paper draws attention to an urgent broader question: as a continuing emphasis on care outside the clinic space places family members at the heart of the care of those with severe mental illness, we ask: who can, and should, support carers, and in what ways?

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Caregivers / psychology*
England
Family Relations
Female
Home Nursing / psychology
Humans
Male
Mental Health Services / organization & administration
Middle Aged
Patient Care Team
Professional-Family Relations
Psychotic Disorders / psychology
Psychotic Disorders / therapy*
Social Support
Stress, Psychological / etiology
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding