An exploration of the commissioning, development and implementation of early intervention services for first episode psychosis in England

摘要

The aim of this longitudinal, qualitative PhD was to explore the commissioning and implementation of early intervention services for first episode psychosis across a number of sites in England. Methods: After a literature review of policy, implementation, and empirical RCT and cohort studies, 147 semi-structured interviews and six focus groups involving 35 people from different managerial and operational levels of the health service were undertaken between February 2004 and March 2009. May’s Normalization Process Theory was used as the underpinning conceptual framework and data were analysed using the Framework Analytical Approach.ududResults: the main findings were the importance of partnership working, influenced positively by the role of a facilitator; challenges which arose when commissioning mental health services, alleviated by the involvement of senior managers acting in a mentor role and the ‘work’ undertaken, from the perspective of Normalization Process Theory. A new service model, called the ‘trailblazer’ early intervention service was identified, which is not accounted for within Normalization Process Theory.ududConclusion: further work is needed to define the characteristics and qualities of the mentoring role of senior managers and the facilitator and explore how best to adapt and extend Normalization Process Theory to incorporate the new ‘trailblazer’ service model.