A qualitative evaluation of a regional Early Psychosis Service 3 years after its commencement
Thomas Callaly A B F , Carmel A. Ackerly B , Mary E. Hyland B , Seetal Dodd B C , Melissa O’Shea B and Michael Berk A B D EA School of Medicine, Deakin University, Geelong, VIC 3220, Australia.
B Barwon Health, Swanston Centre, PO Box 281, Geelong, VIC 3220, Australia. Email: thomas@barwonhealth.org.au; carmel@ackerly.net.au; maryhy@barwonhealth.org.au; melissao@barwonhealth.org.au; mikebe@barwonhealth.org.au
C Department of Clinical and Biomedical Sciences, University of Melbourne, Geelong, VIC 3220, Australia.
D Mental Health Research Institute of Victoria, Parkville, VIC 3052, Australia.
E Orygen Youth Health, Parkville, VIC 3052, Australia.
F Corresponding author. Email: thomas@barwonhealth.org.au
Australian Health Review 34(4) 382-385 https://doi.org/10.1071/AH08731
Submitted: 18 December 2008 Accepted: 28 March 2010 Published: 25 November 2010
Abstract
Objective. To outline the major findings of a qualitative evaluation of an Early Psychosis Service 3 years after its establishment.
Design. Data to evaluate the service were collected from team meetings, focus groups, individual interviews and questionnaires administered to clinicians, school staff, patients, carers and families.
Setting. Barwon Health; Mental Health, Drug and Alcohol Services provide public mental health care to the Geelong, Victoria, region (population 270 000), which is a mixed urban and rural setting. The Early Psychosis Service model implemented involved the placement of two early psychosis workers into each of five adult geographically based Area Mental Health Teams rather than the establishment of a single Early Psychosis Team.
Results. The service was found not to adhere to its original design in several key respects. Caseloads and periods of case management were found to be lower and shorter respectively than was originally planned for, caseworkers often experienced isolation and resentment from their adult service coworkers, the service was perceived to be difficult to access and premises not to be youth friendly and communication and engagement with external agencies and service providers was perceived to be poor.
Conclusions. The choice of service model, inadequate consultation with stakeholders and inadequate promotion of the service contributed to its failure to reach early expectations. Because of these and other issues, including difficulties distinguishing between early psychosis and non-psychosis, a decision was made to restructure youth services and a separate youth mental health service, which incorporated the Early Psychosis Service function, was established.
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