Psychosis As A Gift: A Mixed Methods Study Exploring The Benefits Young People Experience Following A First Episode of Psychosis
Background: A first episode of psychosis (FEP) is arguably the most serious mental health problem affecting youth. However, through the suffering caused by FEP, youth may experience positive, transformational changes, an area which has received very little attention.
Aims: This presentation will answer two research questions: 1) What are the positive changes youth experience following FEP, and 2) What factors and processes facilitate such changes?
Methods: A mixed methods approach combining qualitative and quantitative methods guided this project. For the qualitative component of the study, semi-structured interviews were conducted with 11 youth (n = 11) receiving early intervention services for a FEP. Interviews were transcribed verbatim and subject to thematic analysis using inductive and deductive methods by two researchers. For the quantitative component of the study, we measured overall positive change using the Posttraumatic Growth Inventory (PTGI), which assesses positive change across five domains (e.g., personal strength, relationships, spirituality, life appreciation, new possibilities); social support using the Multidimensional Scale for Perceived Social Support (MSPSS), which assesses perceived support from friends, family, and a special person; and willingness to ask for mental health support using three items from the Recovery Assessment Scale (RAS) (e.g., I know when to ask for help; 2) I am willing to ask for help; 3) I ask for help when I need it). The questionnaires have been well-validated, and were administered between six and 24 months of follow- up. Pearson correlations were calculated between PTGI, MSPSS and RAS scores. Qualitative results: Youth described how FEP led them to feel stronger, more grounded, and more authentic; gain self-awareness, maturity, purpose in, and perspective on life; develop stronger, wiser connections with others; become more spiritually aware; give back to the community through political activism and artistic expression. Youth identified relational and practical processes inherent in the services they received as the most important facilitators of their positive change, including receiving treatment by humane, empathetic and competent clinicians who emphasize their personal and creative strengths; as well as receiving psychotherapy and medication. Finally, participants identified having strong social support, usually from a family member, as key.
Quantitative results: Overall PTGI scores were highly correlated with the friends r(18)=.55, p = .02 and special person r(18) = .52, p = .02 domains of the MSPSS, and with knowing when to ask for help on the RAS r(9) = .70, p = .03.
Discussion: In addition to causing suffering, FEP can be a transformative experience which can be facilitated by the services youth receive, and social support, and knowing when to ask for help. While family were identified as the most important source of support in the qualitative component, friends were found to be important in the quantitative arm. These findings provide an evidence base that services can draw from in order to better provide positive, hopeful, strengths-based services to youth experiencing FEP.