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. 2025 Jan;19(1):e13553.
doi: 10.1111/eip.13553. Epub 2024 May 26.

Referral pathways to early intervention services for psychosis and their influence on perceptions of care: An interpretive phenomenological analysis

Brannon Senger  1 , Quinn MacDonald  1 , Alissa Pencer  1   2   3   4 , Candice E Crocker  3   5 , Jean Hughes  6 , Philip G Tibbo  1   2   3
Affiliations

Referral pathways to early intervention services for psychosis and their influence on perceptions of care: An interpretive phenomenological analysis

Brannon Senger et al. Early Interv Psychiatry. 2025 Jan.

Abstract

Aim: Most young adults experiencing psychosis enter early intervention services (EIS) via inpatient and emergency departments. These experiences are suggested to negatively impact their views of treatment and engagement in EIS. However, limited research has examined the impact of young adults' prior help-seeking experiences on these outcomes. The present study aimed to explore how young adults engaged in EIS have experienced initial help-seeking and make sense of these experiences in the context of their current treatment.

Methods: Using an interpretative phenomenological analysis approach, semi-structured interviews were conducted with 12 young adults (mean age = 24.83) within their first 3-12 months of treatment in EIS. Interviews aimed to examine their experiences of help-seeking and referral to EIS as well as the impact of these experiences on their subsequent perception of, and engagement with EIS.

Results: 3 superordinate themes emerged: (1) Navigating the Maze of Healthcare (2) Dignity and (3) Impact of Help-Seeking and Referral Experiences. Participants with referral pathways involving urgent care services described more adversity during their referral pathway and tended to describe help-seeking experiences as contributing to negative views towards EIS and diminished engagement in treatment.

Conclusions: The impact of early negative experiences with healthcare on views towards EIS and engagement is evident in participants' accounts. Sense making was further contextualized by participants' illness insight, degree of recovery, and social support throughout experiences. Emergent themes highlight the need for psychiatric services to emphasize service users' dignity and for EIS to provide opportunities for patients to process past negative mental healthcare experiences to strengthen engagement.

Keywords: Iatrogenesis; first‐episode psychosis; interpretative phenomenological analysis (IPA); pathways to care; treatment engagement.

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Conflict of interest statement

The author initialled PT has received honoraria for advisory boards and speaker fees for Otsuka, Lundbeck, Janssen, Abbvie and has received an Investigator Initiated Research grant from Janssen that is unrelated to the current research project. Other authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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