ArticleEarly intervention in psychiatry2019
Negotiating the boundaries of psychosis: A qualitative study of the service provider perspective on treatment delay in community mental health.
Article in Early intervention in psychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Developing a spectrum model of engagement in services for first episode psychosis: beyond attendance.Frontiers in psychiatry · 2024Article
- Service providers' perspectives on hoarding management in the community in Singapore.Singapore medical journal · 2022Article
- Clinicians' views of treatment types for first episode psychosis delivered in a randomised controlled trial (MAPS).EClinicalMedicine · 2020Article
- 'It is important for us to see the mentors as persons' - participant experiences of a rehabilitation group.International journal of qualitative studies on health and well-being · 2019Article
- Negotiating the boundaries of psychosis: A qualitative study of the service provider perspective on treatment delay in community mental health.Early intervention in psychiatry · 2019Article
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Authors and funding
5 authors.
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Abstract
aimEvidence shows that many patients are detected and treated late in their course of illness, and that substantial delay occurs even after entry to mental health services. Although several studies have examined the service user and carer perspectives on treatment delay, few have explored the issue from the service provider perspective. The aim of this study was to broaden our understanding of treatment delay by exploring the service provider perspective on reasons for treatment delay in community mental health services.
methodsA qualitative study using data from focus group interviews with 33 healthcare professionals in community mental health care. Interview data were digitally recorded and transcribed verbatim, and analysed using a grounded theory approach.
resultsService providers perceived divergent or conflicting perspectives as the main challenge in early psychosis. Clinical negotiation was chosen as the main term describing the interactions between patients and healthcare professionals: This was observed in 3 overlapping areas: (1) Negotiating the patients status as help-seeker; (2) Negotiating the place and conditions of treatment and (3) Negotiating the meaning of distressing experiences and the timing of treatment options.
conclusionsThis study suggests that delay in initiation of treatment for psychosis in community mental health is related to clinical challenges of early disengagement from services and diagnostic uncertainty. Service providers found negotiating the therapeutic relationship and patient-centred flexibility more useful in ensuring engagement than an assertive outreach approach. Diagnostic uncertainty was resolved through watchful waiting using a distress-overload conceptualization in assessing changes in mental state and service needs.
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