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BMC Psychiatry
Published in: BMC Psychiatry 1/2019

Open Access 01-12-2019 | Research article

The missing voice of engagement: an exploratory study from the perspectives of case-managers at an early intervention service for first-episode psychosis

Authors: Rachel M. Tindall, Kelly Allott, Magenta Simmons, Winsome Roberts, Bridget E. Hamilton

Published in: BMC Psychiatry | Issue 1/2019

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Abstract

Background

A key component of case-management in early intervention services for first-episode psychosis is engaging a person with the service and building a relationship from which therapy and treatment can be facilitated. The aim of this study was to understand how case-managers at an early intervention service experience the process of engagement and working with varying levels of attendance and participation.

Methods

Qualitative interviews were conducted with the case-managers of nine young people treated at an early intervention service for first-episode psychosis within 6 months of treatment entry. Interviews discussed the process of working with the young person and factors that influenced service engagement. Interviews were analyzed using thematic analysis.

Results

Case-managers described a range of influences on engagement which were grouped under the themes: young person and caregiver influences on engagement, case-manager influences on engagement, and influences of the early intervention service system on engagement. The experience of engagement was described as relational, however it occurred in the context of broader influences, some of which were unable to be changed or challenged by the case-manager (e.g., resource allocation, models of treatment, young person demographics).

Conclusion

This study illustrates the challenges that case-managers face when working with young people with first-episode psychosis, and the direct influence this has on engagement with treatment. Understanding these challenges and addressing them in policy and service design may lead to improvements in young peoples’ recovery from first-episode psychosis and increase case-manager job satisfaction.
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Metadata
Title
The missing voice of engagement: an exploratory study from the perspectives of case-managers at an early intervention service for first-episode psychosis
Authors
Rachel M. Tindall
Kelly Allott
Magenta Simmons
Winsome Roberts
Bridget E. Hamilton
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2019
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-019-2315-0

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