Service users with psychotic illness highlighted dissatisfaction with crisis services. National clinical guidelines recommend the provision of crisis care for those experiencing acute psychosis, however they do not offer clear specifications around the optimal delivery of a Crisis Resolution Team (CRT) intervention for this population. In response to this need, this study explored the barriers and facilitators to the provision of crisis care for people with psychosis. This topic has not been addressed previously in the literature and the results represent a novel contribution to the evidence base. Semi-structured in-depth interviews were used in order to examine the views of service users with psychotic illness and CRT staff, to better understand what works well with crisis care and what could be improved. Thematic analysis, utilising a data-driven inductive approach, was used to scrutinise the data in order to identify and analyse patterns and themes. Four primary themes emerged in the analysis i). Relationships – The service user and CRT staff relationship ii). Communications – The role of information and knowledge for service users and communication between participant groups. iii). Features of Psychosis – The impact of the symptoms of psychosis and risks to selves and others upon delivery of crisis care. iv). Power and control - power dynamics in the relationship between the two participant groups and the locus of control for service users in relation to their relationship with CRT staff and at a broader systemic level. The themes were often interrelated, with experiences unique to psychosis meeting with systemic barriers unique to the point of crisis care. A series of recommendations are made as a result of these findings. These include i).methods to support service users regain control during the acute period ii). The need for a biopsychosocial approach and iii). The need for national guidance around thresholds for treatment of psychosis for CRTS.
Crisis Response for Psychosis: A qualitative study examining the barriers and facilitators to the provision of crisis care for people with psychosis.
Piotrowski, J. M. (Author). 1 Oct 2019
Student thesis: Master's Thesis › Master of Science by Research (MScR)