0037 MAKING SENSE OF FIRST EPISODE PSYCHOSIS: EXPERIENCES AND PERCEPTIONS OF “ILLNESS”

Early intervention services face the challenge not only of identifying psychosis early in onset, but also of providing a more acceptable service for their clients that will maximise engagement and increase adherence to evidence-based interventions. Research related to engagement and adherence in psychosis has traditionally focused on the concept of insight, however, only a limited relationship has been established between insight into “illness” and engagement, treatment adherence and outcomes (David, 1998). In the arena of physical illness, some significant steps forward have been made in exploring such issues. By investigating people’s own subjective beliefs and sense making when faced with a health threat, health psychologists have developed the concept of “illness perceptions” and explored how these influence illness related behaviour. Using this illness perceptions framework, links have been found between illness beliefs, engagement, treatment adherence and outcomes in many areas including cancer, diabetes and heart disease (Petrie & Weinman, 1997). To date, there has been no published qualitative research into what beliefs people with fist episode psychosis actually have about their experiences, and hence how they chose to act. A better understanding of this would clearly be useful to inform the development of sensitive and effective early intervention services. This study aimed to redress this gap by exploring the experiences and perceptions of twenty people recently diagnosed with first episode psychosis. Semi-structured interviews were conducted with participants, transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). The participants described several processes and dilemmas as they sought to make sense of what had happened to them. Particular dilemmas for clinicians and clients alike are explored related to detecting psychosis early, coming into contact with services for the first time, providing education and information, relating to other patients, coping and recovery, and long term engagement.