Case study 3 – RfPB
Case study 3 – Improving Early Youth Engagement in first episode psychosis: The (EYE-2) study
Early intervention in the first 3 years of psychosis can improve long-term outcomes and reduce hospital admissions and suicide risk. Around 7,500 young people in England every year develop psychosis which generally begins between ages 14-35.
Unfortunately, a quarter of young people disengage with Early Intervention in Psychosis (EIP) services in the first year, at significant cost to their mental health, their families, society and the NHS.
Dr Kathryn Greenwood of Sussex Partnership NHS Foundation Trust previously carried out a successful NIHR Research for Patient Benefit (RfPB) feasibility study and pilot of a team-based motivational intervention – EYE (Early Youth Engagement) to improve engagement and outcomes for young people.
The EYE project aimed to reduce disengagement by developing a new approach with young people, parents and EIP staff. EYE addresses issues that may put people off, such as how staff talk to them, how much family and friends are included, and how services help with goals, treatment choices and preferences. Support resources include a website, booklets co-written with young people, and staff training using motivational techniques.
In the RfPB study, more young people were engaged with the new approach at 12 months. It improved isolation, trust, personal goals, communication, shared decision-making and family involvement.
Dr Greenwood wanted to apply for funding to build on this previous work with the EYE intervention. She contacted RDS SE in Brighton and RDS SE Research Adviser Claire Rosten supported her throughout the application process. Claire also advised the team on comments fed back from the funding panel. An RDS SE PPI Grant helped the team build strong patient and public involvement (PPI) into every stage of the project. In 2018 the NIHR Health Services and Delivery Research Programme awarded £1.5m for a three-year pragmatic cluster randomised controlled trial.
The EYE-2 study will build on the previous work, refining and testing the intervention. It aims to improve services so that more people who have a first episode of psychosis stay engaged and benefit from them. The research will use the new intervention, adapted for people from ethnic minorities, with 720 young people in 18 EIP services in Manchester, London and the South of England. Half the services will deliver EYE and the remainder the existing pathway. The main outcome will be whether EYE helps keep young people engaged with services.