Exploring Young People's Constructions of a First Episode of Psychosis

Background: Mental health services have been demonstrated to play a key role in shaping how people make sense of their experiences of psychosis. Past research has highlighted the dominance of the biomedical model within services, however, first-person accounts suggest this is not always meaningful or helpful for recovery. Early Intervention in Psychosis (EIP) services aim to provide a more holistic, non-stigmatising approach for young people experiencing a First Episode of Psychosis (FEP). However, there is very limited research exploring how these services might impact upon how young people construct their experiences. This study aimed to explore the culturally available narratives drawn upon by young people accessing EIP services and the consequences of these for service utilisation and subjectivity. Method: Semi-structured interviews were carried out with five young people (aged 18-35) who were accessing an EIP service for a FEP. A Narrative Analysis (NA) approach facilitated exploration of how young people constructed their experiences of a FEP and how they narrated this had changed since accessing the EIP service. Results: The participant’s narratives emphasised the idiosyncratic ways they constructed their FEP, drawing on a range of culturally available discourses. While accessing the EIP service appeared to facilitate the exploration of a range of casual theories, often drawing on a biopsychosocial model, their narratives also highlighted the implicit power of the biomedical approach in shaping their sense of self and the future. Conclusions: The findings support previous literature that highlights the importance of meaning-making for young people experiencing a FEP. The discourses available within EIP services appear to play a key role in shaping young people’s constructions and this study highlights the value of privileging multiple perspectives when supporting people to make sense of their experiences of psychosis