Trajectories and challenges of re-accessing services following discharge from Early Intervention in Psychosis

Robinson, Claire (2026) Trajectories and challenges of re-accessing services following discharge from Early Intervention in Psychosis. Doctoral thesis, University of East Anglia.

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Abstract

Background: Early Intervention in Psychosis (EIP) services support individuals with psychosis for up to three years. Most patients are discharged to primary care following EIP involvement. Transitions between services are risky times for patients, leading to increased uncertainty and instability, increasing the risk of relapse. Many patients experience relapse following discharge from EIP, requiring additional support from mental health services. Care pathways and help-seeking following EIP discharge is an under-researched area. Understanding and improving care pathways can improve service provisions and patient outcomes.

Methods: A systematic review was conducted exploring care pathways following discharge from EIP services, including predictive factors and long-term outcomes. A qualitative study was conducted exploring service-user experiences of re-accessing mental health services following discharge from EIP, using semi-structured interviews and analysed using thematic analysis.

Results: 17 papers met the inclusion criteria for the systematic review. Three care pathways were identified: primary care, secondary care and tertiary care. Earlier studies reported secondary care as dominant discharge destination, whereas more recent, higher quality studies found primary care to be most common. The review reported on predictors for discharge destinations including patient characteristics and EIP treatment factors. In the empirical study, ten participants were interviewed about their experiences of re-accessing care and barriers or facilitators to help-seeking. Themes centred around significant systemic barriers including resource scarcity, rigid service processes and strict eligibility criteria; alongside interpersonal barriers related to stigma, identity, trust and safety. Facilitator themes related to ‘safer support’ and relationships.

Conclusions: The thesis portfolio identified the need for flexible, adaptable and relationally safe services for supporting access to care and engagement. Change to service design should be guided by service-users’ experiences. Future research should explore family and clinician experiences of post-EIP care pathways, given they often advocate for loved ones and help navigate services.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	09 Nov 2026 11:35
Last Modified:	09 Nov 2026 11:35
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105015
DOI:

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