Case management in early psychosis intervention programme: Perspectives of clients and caregivers

Abstract

Aim: This qualitative study explored the perspectives of clients and caregivers on case management provided by the Singapore Early Psychosis Intervention Programme (EPIP), with the intent to understand the salient aspects of case management from their perspective.Methods: Clients and their caregivers were recruited from the EPIP outpatient clinics. Focus group discussions (FGDs) were conducted at a community centre outside the hospital with 47 clients and 19 caregivers. Facilitators were experienced researchers who were not involved in the care of the clients and trained in qualitative research methodologies. All FGDs were audio recorded and transcribed verbatim with all participants' identifiers omitted to protect confidentiality. Qualitative data analysis was conducted using thematic analysis.Results: There were 11 themes that emerged from the FGDs: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, bridging role, client-centred care, client empowerment and strength building, psychoeducation/education on illness, support and problem solving. "Problem solving" surfaced only from the client FGDs; the remaining themes were common to both groups. Conclusions:The voices of clients and caregivers are important to EPIP case management service. This study has provided insights into their perspectives, understandings and lived experiences of case management and its impact on clients and caregivers. K E Y W O R D Scaregiver perspective, case management, client perspective, early intervention, psychosis

The role of key workers in improving physical health in first episode psychosis: A scoping review

“…Two qualitative studies (Lester et al, 2012; Wong et al, 2017) discussed the role of key workers in facilitating discussions on physical health issues. Of these, one study identified enhanced engagement in such discussions that was facilitated by a key worker (Wong et al, 2017). The study found that key workers engaged FEP patients on various topics, including diet and exercise to manage weight gain from psychotropic medications.…”

“…One qualitative study identified the role key workers played in enhancing monitoring of FEP patients (Wong et al, 2017). Key workers were found to provide comprehensive monitoring of patients in the biological, psychological, social and spiritual domains of their health, which was deemed important given the multiple factors that could contribute to FEP patients' risk of relapse.…”

Implementing civic engagement within mental health services in South East Asia: a systematic review and realist synthesis of current evidence

“…Sharing experiences of poor mental health and developing a shared understanding of collective traumas and conflict brought people together, developed new networks of social support, and had the potential to improve mental health and quality of life. CE also developed people's understanding of mental health and equipped communities with new knowledge and skills which could be used to meet the needs of local people experiencing mental health problems [40,65]. These initiatives could be particularly valuable in building community resilience and preparedness for natural disasters.…”

“…Where interventions or approaches incorporating elements of civic engagement were described, the majority featured uptake or adaptation of Western models of care, such as shared decision making [39], early intervention for psychosis services, including elements of joint care planning or shared decision making [40,41], or peer led self-management programs [35,36,42]. Other interventions were developed by clinicians or other professionals based in South East Asia [43][44][45][46], or by members of the local community itself [46][47][48].…”

“…Included studies demonstrated how such approaches could provide normalisation and validation of people's experiences in South East Asian populations [70]. Interventions that were able to equip service users, family members and communities with knowledge and skills about mental health empowered service users to take responsibility for managing their own illness and gave family members and communities the confidence to support service users better [40,65]. As a result, civic engagement interventions could improve mental health and quality of life for service users and carers (O2 [35,36,39,40,42,67,71]).…”