How engaging with early intervention services can change the lives of young people with psychosis

2 December 2024

The lives of young people with psychosis are being transformed due to a new study focussing on early intervention.

The study is led by researchers at Sussex Partnership NHS Foundation Trust (SPFT) and funded by National Institute for Health and Care Research (NIHR).

Research looking at first episodes of psychosis has previously discovered that the earlier an intervention is carried out, the better the outcome for patients.

Our initial Early Youth Engagement work involved a comprehensive look into issues that can put young people off addressing their mental health issues, such as lack of inclusion of family and friends in discussions about treatments, how staff interact with young people and how staff can support young people with their goals and treatment choices.

Service users and carers said that the EYE approach helped with isolation, trust, personal goals, better communication with the service, shared decision making with staff, and family involvement.

The EYE-2 (Early Youth Engagement) approach includes a website, booklet series co-written with young people, and other resources to support young people and families, and a training programme for staff in how to work flexibly, honestly and openly using key, well established 'motivational' techniques to help young people achieve their goals.

Kathryn Greenwood, Professor of Clinical Psychology at SPFT and University of Sussex, said: "This was the largest ever real-world whole population study of outcomes for young people in UK EIP (Early Intervention in Psychosis) services – no-one was excluded from the study.”

"This is important because this means that our findings are highly representative of what happens day-to-day in EIP services across the UK."

The study found that the novel Early Youth Engagement (EYE-2) intervention is a low-cost therapeutic approach with psychoeducational booklets and website co-produced with service users, families and clinicians that are well-liked, safe and easy to use to engage young people and families in psychosis services and for the training and induction of new staff.

The Early Youth Engagement (EYE-2) intervention is associated with lower unplanned inpatient service costs and social and occupational benefits, with six weeks more time in education and training per year, and more time in employment and stable housing.

Approximately 10,000 young people in England develop psychosis every year. It's a severe mental health problem that generally starts in people aged 14-35 years and has long-term effects on the individual and society. Early intervention in the first three years of psychosis can improve long-term outcomes.

The new EYE-2 approach in EIP services has been developed with young people, their parents and Early Intervention in Psychosis (EIP) staff.

Craig Mackie was under the Early Intervention services for three years after developing psychosis in his twenties. He said being part of this 'changed his life' and he is now a peer support worker, helping others with psychosis.

"Having psychosis can be debilitating and there is a lot of stigma attached to it," he said.

"The most helpful thing for me when I was under the Early Intervention in Psychosis Services, is being able to meet up with people going through a similar thing to myself and being in a space knowing that I’m not being judged.

"This provides such fantastic support and something that I have helped to set up within my team, but also to keep it running and grow it from strength to strength to help the people we work with.”

"I got back into work through the EYE-2 research project. This is where I learnt about the EYE-2 booklets and the website.

"These are amazing resources and are still used by myself and the teams I work in now. I direct people to use the website as a resource as it can be used by both patients, families and friends as well as the public."

"The website covers loads of different topics from telling peoples own stories of Psychosis to treatment options as well as advice and support."

The study involved randomising 20 teams with 1027 young people between May 2019 and July 2020 to either receive the EYE-2 approach or a standard EIP service.

Alongside the societal and cost benefits we can also see that across England disengagement of young people from Early Intervention in Psychosis services is low. Health and recovery outcomes are generally good but 16% still disengage.

Clinicians, families and young people can find supportive resources and booklets here

This research has been exclusively published in the British Journal of Psychiatry – you can access the most recent paper here.

Papers from the pilot project, ethnic minority and LGBTQ+ representation and big data analysis are also available by clicking the links.