Work Package 1 (implementation study) Inclusion – Clinician or manager working within a Sussex EIP team who took part in the original EYE study in Sussex. Work Package 2 (ethnicity/minority study) Inclusion – EIP service users with psychosis aged 14-35 from the main regionally identified ethnic minority and other minority (e.g. LGBT) populations at each identified site. Work Package 3 (RCT study) Inclusion criteria are: (i) Consecutive referrals to the service during the study recruitment period aged 14-35; (ii) meeting criteria for a first episode of psychosis (FEP) as determined by each local service according to their own established criteria. The inclusion criteria used to make these decisions will be recorded for each service, and made available for subsequent inspection. Work Package 4 (Process evaluation study) Inclusion criteria – EIP clinicians delivering EYE-2 and/or EIP services as part of the RCT. Work Package 5 (cost-effectiveness study) Inclusion as outlined for WP3 but with at least 12 months EIP contact.
Work Package 1 Exclusion – EIP clinicians who started work in a Sussex EIP team after the completion of the original EYE project in November 2015. Work Package 2 Exclusion – EIP service users with ARMS diagnoses and/or service users who are over 35 year olds Work Package 3 Exclusion criteria are (i) a sub-threshold ‘at risk mental state’, not meeting FEP criteria, (ii) referral over the age of 35, (iii) referrals where there is remaining diagnostic uncertainty about psychosis at 12 months. Participants will be withdrawn from the study if (i) they move to a mental health service outside the study or (ii) they move to a service that is in a different arm of the EYE project. Work Package 4 Exclusion criteria – EIP clinicians who are in the EYE-2 arm but who did not attend the training and/or commenced work with the service after EYE-2 had started. Work Package 5 Exclusion as outlined in WP3.
Psychosis is a severe mental health problem that generally starts in people aged 14-35. Approximately, 7,500 young people in England develop psychosis every year. People with psychosis die up to 25 years earlier than the general population and the financial cost to society is high. Early Intervention can improve long term outcomes so that people have fewer symptoms and hospital admissions, better health, and reduced suicides. Yet, a quarter of all young people drop out of services in the first 12 months leading to greater risk of poor health and service use. Ensuring that young people receive a service quickly is an NHS priority, but there are no interventions to improve engagement. This project is about improving services for people who have a first episode of psychosis so that more people want to stay with the service. The first Early Youth Engagement (EYE) project developed a new intervention with young people, parents and Early Intervention in Psychosis (EIP) staff. The intervention includes a website, booklets and other resources; and a training programme for staff in how to work flexibly and openly using key, well established “motivational” techniques to help young people achieve their goals. Our pilot study, improved engagement at 12 months. We now want to test the EYE intervention with 950 young people in 20 EIP services in Manchester, London, Norfolk, Cambridge and the South of England: half the services will deliver the EYE intervention and half will work as usual. We will adapt EYE resources for people from minority populations and will evaluate how the intervention is delivered. The measure of success will be whether more young people stay engaged in the service, as well as whether they have better mental and physical health, work and social life, recovery, service satisfaction, and whether the approach saves money.
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