Barriers and Opportunities for Collaboration With Primary Care: Perspectives of Early Psychosis Intervention Programs in Ontario, Canada.

backgroundCollaboration between early psychosis intervention (EPI) services and primary care is crucial for continuity of care for first-episode psychosis. The aim of this study was to describe the perceptions of staff at EPI programs on barriers and opportunities for collaboration with primary care.

methodsWe conducted a qualitative descriptive study using focus groups with staff at six EPI programs across Ontario, Canada (2 rural, 4 urban) with 2-9 participants per focus group (total n = 39). Focus group sessions were audio recorded and transcribed verbatim. We used thematic analyses to code the transcripts and identify emergent themes.

resultsParticipants highlighted three points in the EPI treatment process where collaboration with primary care is important: during the referral/intake process, shared care throughout treatment, and at discharge from the EPI program. We identified four themes relating to broader structural issues impacting collaboration with primary care through the treatment process: client access to primary care, family physician knowledge of early psychosis, siloed communication structures, and time constraints for both EPI staff and family physicians.

conclusionsImproving primary care access in young people, increasing family physician knowledge of psychosis and EPI services, and allowing dedicated time for communication for both family physicians and EPI clinicians may improve collaboration and patient care through the processes of intake, ongoing care, and discharge from EPI services.