Experiences of service transitions in Australian early intervention psychosis services: a qualitative study with young people and their supporters

BMC Psychiatry

Research

Tacita Powell¹  Rochelle Einboden²  Niels Buus³  Katrina Conn⁴  Alyssa Milton⁵  Nicholas Glozier⁵ 

[1] Adolescent Court and Community Team Justice Health and Forensic Mental Health Network, Sydney, Australia;Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Canada;Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia;School of Nursing and Midwifery, Monash University, Clayton, Australia;Department Regional Health Research, University of Southern Denmark, Odense, Denmark;Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, 2050, Camperdown, NSW, Australia;NSW Department of Education, Sydney, Australia;Sydney School of Medicine (Central Clinical School), Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, 2050, Camperdown, NSW, Australia;The University of Sydney and Australian Research Council (ARC) Centre of Excellence for Children and Families over the Life Course, Sydney, Australia;

关键词: Early psychosis services;    EIP;    Care transitions;    Mental health;    Service user involvement;    Qualitative;    Young people;    Families, carers and support people;    Australia;   

DOI  :  10.1186/s12888-022-04413-0

 received in 2022-02-28, accepted in 2022-10-17,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundDifferent Early Intervention Psychosis Service (EIPS) models of care exist, but many rely upon community-based specialist clinical teams, often with other services providing psychosocial care. Time-limited EIPS care creates numerous service transitions that have potential to interrupt continuity of care. We explored with young people (YP) and their support people (SP) their experiences of these transitions, how they affected care and how they could be better managed.MethodsUsing purposive sampling, we recruited twenty-seven YP, all of whom had been hospitalised at some stage, and twelve SP (parents and partners of YP) from state and federally funded EIPS in Australia with different models of care and integration into secondary mental health care. Audio-recorded interviews were conducted face-to-face or via phone. A diverse research team (including lived experience, clinician and academic researchers) used an inductive thematic analysis process. Two researchers undertook iterative coding using NVivo12 software, themes were developed and refined in ongoing team discussion.ResultsThe analysis identified four major service-related transitions in a YP’s journey with the EIPS that were described as reflecting critical moments of care, including: transitioning into EIPS; within service changes; transitioning in and out of hospital whilst in EIPS care; and, EIPS discharge. These service-related transition affected continuity of care, whilst within service changes, such as staff turnover, affected the consistency of care and could result in information asymmetry. At these transition points, continuity of care, ensuring service accessibility and flexibility, person centredness and undertake bio-psychosocial support and planning were recommended. State and federally funded services both had high levels of service satisfaction, however, there was evidence of higher staff turnover in federally funded services.ConclusionService transitions were identified as vulnerable times in YP and SP continuity of care. Although these were often well supported by the EIPS, participants provided illustrative examples for service improvement. These included enhancing continuity and consistency of care, through informed and supportive handovers when staff changes occur, and collaborative planning with other services and the YP, particularly during critical change periods such as hospitalisation.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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Fig. 1