Case managers’ experiences of engagement with service users in UK early intervention services for first-episode psychosis: A hermeneutic interpretive phenomenological analysis study

Aim: Staff engagement with individuals with First-episode psychosis (FEP) in Early Intervention Service (EIS) settings is important to reduce the longer-term impact of this condition and promote recovery. There is a paucity of qualitative evidence exploring engagement from the perspectives of staff in these settings. This study aimed to explore and understand Case Managers’ experiences of engagement with service users in EIS settings in the UK.

Method: Hermeneutic Interpretive Phenomenological Analysis (IPA) using semi-structured interviews with purposively sampled EIS case managers with mental health nursing backgrounds from a single NHS Trust in the North of England. Data analysis followed IPA’s six stages.

Results: Five master themes were identified as being key to effective engagement: (1) Being on the same page; (2) Engagement as an interpersonal relationship; (3) Managing self and emotions; (4) The practicalities of engagement and (5) The impact of organisational factors upon engagement. Engagement was experienced as multi-faceted, complex, and changeable. Key engagement strategies identified as helpful were trust, therapeutic dialogue, shared understanding, collaboration, and practical approaches.

Conclusion: Engagement in the context of EIS can be defined as a mutually beneficial connection that takes place between service users and staff which allows for implementation of treatment. Engagement strategies are an important consideration to reduce the potentially devastating impact of FEP, and to facilitate recovery. Further exploratory research should be conducted across multiple settings, to further build on and understand engagement within the wider EIS context