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

Br J Psychiatry

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.

Published: August 2015

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?

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http://dx.doi.org/10.1192/bjp.bp.114.146415	DOI Listing

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