ABSTRACT
Introduction
Despite a solid evidence base, mental health services often struggle to implement family interventions as part of routine psychosis care. Barriers to implementation include staff lacking training, supervision and confidence, as well as organisations lacking resources and prioritising crisis-focused interventions. Specific barriers in the early psychosis context include family readiness and interest, access limitations, and lack of perceived alignment with their needs and preferences. This paper describes and evaluates a pragmatic family education and support program in an Australian public mental health Early Psychosis service.
Methods
This uncontrolled pre-post study used routinely collected data. Data were retrospectively sourced from clinical and administrative records for the 2022–2023 period, during which a low-intensity (four-session) multi-family group program was run on four occasions. A routine voluntary pre- and post-participation survey was completed, which included consideration of the extent to which the program met participants’ needs. Data were primarily considered using repeated measures t-tests and Cohen’s d as a measure of effect size.
Results
Less than half of the families invited to the program participated (38.8%). Despite the program’s low intensity, it was reported to meet the needs of most participating families and caregivers. Participants reported significantly increased knowledge of psychosis and reported higher levels of coping with symptoms at post compared with pre-intervention measures. An increased number of sessions attended predicted improvements in knowledge (limited to ‘relapse’) but not coping.
Conclusion
A low-intensity family education program in the early psychosis project may meet the needs of most families and caregivers who are willing to engage. However, improvements in coping were modest and variable across participants, and the clinical significance of this change should be interpreted cautiously. Such a program may be inadequate to consistently meet the needs of all families engaged with an early psychosis service. Public mental health services need to continue to find better ways to engage and support the families of people experiencing early psychosis.