Abstract
Objectives
Early intervention in psychosis (EIP) services provide care for individuals experiencing first-episode psychosis and are considered both clinically and cost-effective. While many have positive experiences of EIP, there have also been reports of perceived harm. This scoping review synthesized qualitative evidence on service user perspectives of potential harm in EIP services in the UK, to consider how services may continue to improve practice to meet the needs of their service users.
Methods
We conducted a scoping review following a pre-registered protocol. Systematic searches were performed in PsycINFO, Web of Science Core Collection, Scopus, Embase, CINAHL Plus and Medline on 9th October 2024, and updated searches on 12th January 2026. We included peer-reviewed qualitative studies exploring service user experiences in EIP services in the UK. Data on reported harms from eligible studies were thematically analysed.
Results
Thirteen studies met inclusion criteria. We identified four main themes: (1) Intersection of stigma and lack of cultural awareness; (2) Inappropriate or inadequate support; (3) Poor relationships and communication; and (4) Challenges in the discharge process.
Conclusions
While EIP services offer the current gold standard of care for first-episode psychosis, our review highlighted some areas where harm was perceived to have arisen. Such information presents potential targets for service improvement. Strengthening communication and enhancing information sharing may help mitigate potential harms and optimize service user experiences. Further research to quantify the prevalence of harms within EIP services is needed to inform best practices and ensure equitable, person-centred care.