“We all have a responsibility”: a narrative discourse analysis of an information campaign targeting help-seeking in first episode psychosis

Abstract

Background Intervening at an early stage of psychosis improves the chances of recovery from first-episode psychosis. However, people who are experiencing distress and early psychotic symptoms generally seem to delay seeking help. Therefore, multifaced information campaigns targeting help-seeking behavior of potential patients and their network are considered important tools within early detection and intervention strategies. In this study, we aimed to explore which discursive meaning content, including roles and actors, such information campaigns build on and construct. Our intention was not to provide objective answers, but to contribute to a discursive debate about potential conflicts in messages conveyed in such campaigns. Methods A broad sample of information material utilized by TIPS Stavanger University Hospital (Norway) was examined. The material consisted of posters, booklets and brochures, newspaper ads, Facebook ads, and TIPS Info’s website, representing various campaigns from 1996 to April 2018. A narrative discursive approach was applied at an epistemological level. At a practical level, a team-based thematic analysis was utilized to identify patterns across data. Results Diversity and several changes in strategy were recognized throughout the information material. Furthermore, three main themes and four subthemes were found to constitute the meaning content built in the information campaigns: knowledge is key; (almost) an illness among illnesses; and we all have a responsibility (comprising of the subthemes; to respond quickly; to step in; to provide an answer; and to tag along). Conclusion Our findings pointed to common dilemmas in mental health services: How to combine professional expert knowledge with collaborative practices that emphasize shared decision-making and active roles on behalf of patients? How to combine a focus on symptoms and illness and simultaneously express the importance of addressing patients’ recourses? And how can we ask for societal responsibility in help-seeking when professionals are placed in expert positions which may not be optimal for dialogue with potential patients or their network? We discuss whether highlighting practices with more weight on resources and active roles for patients and their surroundings in information campaigns could promote earlier help-seeking. Electronic supplementary material The online version of this article (10.1186/s13033-019-0289-4) contains supplementary material, which is available to authorized users.

Affirmative Care Across Cultures: Broadening Application

“…Collaborative decision making is a process of engagement in which provider and patients (and their loved ones) work together, using information to understand clinical issues and to determine the best course of action. Moving beyond the two-way knowledge exchange proposed in the shared decision-making model, the exchange of information leads to the development of a stronger partnership between the patient and the provider (48). The first step is creating a strong patient-provider relationship in which traditionally disenfranchised communities are respected.…”

“Needing different things from different people” – a qualitative exploration of recovery in first episode psychosis

“…I diskursanalysen fant vi nettopp at opplisting av symptomer ble benyttet som en sentral strategi for å formidle kunnskap om psykose. Denne kunnskapen skulle hjelpe publikum med å gjenkjenne tidlige tegn på psykose (Hansen et al, 2019b). Funnene fra studien som helhet peker også i retning av at psykose i hovedsak ble omtalt innenfor en sykdomsdiskurs.…”

“…Psykose som konsept så likevel ikke ut til å passe helt og holdent inn i en slik forståelsesramme. Av den grunn kalte vi et av temaene i diskursanalysen for (Nesten) en sykdom som andre sykdommer (Hansen et al, 2019b). Psykose ble nemlig ikke utelukkende formidlet som en sykdom som ligner andre (kroppslige) sykdommer.…”

“…Noe av grunntanken bak tidlig intervensjon handler nettopp om å komme så tidlig på banen at man avverger utvikling av alvorlige og langvarige psykoselidelser (Bertolote & McGorry, 2005;Johannessen et al, 2006;McGorry, Yung & Phillips, 2001). Et av temaene i diskursanalysen belyste nødvendigheten av å respondere raskt (Hansen et al, 2019b). Det gjaldt ikke bare helsetjenesten, man appellerte også til folk rundt og Dette spenningsfeltet kaster også lys på epistemologiske forskjeller mellom de to hovedforståelsene innenfor den psykiske helsetjenesten.…”

“…Denne strategien så vi også i de tidlige annonsene i diskursanalysen. Forebyggende arbeid mot føflekkreft ble for eksempel brukt som et bilde på hvordan man kunne drive forebyggende arbeid mot psykose(Hansen et al, 2019b). Ifølge er tanken bak en slik strategi at det vil vaere mindre belastende å bli sett på som syk enn som en som ikke klarer å kontrollere atferden sin, oppfører seg avvikende fra det normale eller er gal.…”