The Early Youth Engagement (EYE) project: A feasibility and pilot study to promote better engagement and outcomes in first episode psychosis

Background: Engagement with Early Intervention in Psychosis (EIP) services improves symptoms, illness course, social and occupational function, yet, 25-30% of patients disengage from services within the first 12 months. This study aimed to develop an intervention to promote better youth engagement and health outcomes for this population.Method: First, a cross-sectional qualitative study investigated facilitators and barriers to engagement from the perspective of EIP service users, their relatives and healthy young people. Forty focus groups/ interviews were conducted with 68 participants, and thematic analysis was applied to the transcribed data. Next, a Delphi consultation with 27 clinicians, managers and experts, reached consensus on a set of pragmatic, deliverable service adaptations which formed the new Early Youth Engagement (EYE) service model. Finally, 298 first episode psychosis services users received either the original model (pre-adaptation) or the EYE model (post-adaptation), and both engagement at 12 months, and feasibility and satisfaction were explored.Results: A generalized linear model with engagement status nested within teams, revealed that the proportion disengaged was significantly lower in the EYE model cohort. Engagement was not predicted by team, age or gender. Disengagement decreased from 24% prior to 14.5% post the intervention. Qualitative feedback revealed impacts on communication, social involvement, staff approaches, collaboration, practical goals, hope and trust.Conclusion: This study demonstrates how a new early youth engagement model might reduce drop out, and promote satisfaction and better social and health outcomes for this sub-group of young people at risk of disengagement.</p