Engagement, Disengagement and Re-Engagement in Mental Health Services Among Young Patients With First-Episode Psychosis: A Scoping Review

IF 2.2 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry Pub Date : 2025-10-09 DOI:10.1111/eip.70100

Joyce Mlay, Saeeda Paruk, Andrew Tomita, Richard Lessells

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Abstract

Introduction

Engagement in mental health services among young patients with first-episode psychosis (FEP) is crucial for preventing relapse. We conducted this scoping review to establish the proportion and determinants of engagement, disengagement and re-engagement in outpatient mental health care among young patients from 13 to 35 years with FEP.

Methods

We used the guidelines for scoping review by the Joanna Briggs Institute (JBI) and the Arksey and O'Malley framework. We searched for published and unpublished studies guided by the inclusion criteria: studies published in English from 1990, the expansion of psychiatric outpatient, focused on engaged, disengaged and re-engaged in outpatient mental health care using quantitative, qualitative and mixed methods studies. We performed the numerical and thematic analysis and reporting using Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for scoping review (PRISMA-ScR).

Results

About 25 articles published from 2002 to 2020 met the inclusion criteria for this review; the proportion of young people with FEP who remained engaged was 45.5% for 6 months of follow-up, and the proportion of re-engagement after initial disengagement was 78.8%. Disengagement ranged between 13% and 56.3% for 12–36 months. The socio-demographic factors associated with disengagement were older age, male, black, unmarried status, living alone, unemployment, social and material deprivation, poverty, substance use and involvement with criminal justice. Some clinical determinants included a history of mental illness in the family and a psychosis disorder diagnosis other than schizophrenia.

Conclusion

Disengagement from mental health services is consistently high among people with FEP, indicating the need for intervention studies that address the associated individual and clinical factors to ensure their retention in treatment.

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青少年首发精神病患者心理健康服务的参与、脱离和再参与：一项范围回顾

简介：参与精神卫生服务的年轻患者首发精神病（FEP）是预防复发的关键。我们进行了这一范围综述，以确定13至35岁的FEP年轻患者在门诊精神卫生保健中参与、退出和再参与的比例和决定因素。方法：我们使用乔安娜布里格斯研究所（JBI）和Arksey和O'Malley框架的范围审查指南。我们在纳入标准的指导下检索已发表和未发表的研究：1990年以来发表的英文研究，精神科门诊的扩展，使用定量、定性和混合方法研究，重点关注门诊精神卫生保健的参与、不参与和重新参与。我们使用系统评价的首选报告项目和范围评价的元分析扩展（PRISMA-ScR）进行了数字和主题分析和报告。结果：2002 - 2020年间发表的约25篇文献符合本综述的纳入标准；在6个月的随访中，有FEP的年轻人保持参与的比例为45.5%，最初脱离后再次参与的比例为78.8%。在12-36个月内，脱离接触的比例在13%到56.3%之间。与脱离接触有关的社会人口因素是年龄较大、男性、黑人、未婚、独居、失业、社会和物质剥夺、贫困、药物使用和刑事司法。一些临床决定因素包括家族精神病史和除精神分裂症以外的精神障碍诊断。结论：FEP患者从心理健康服务中脱离的比例一直很高，这表明需要进行干预研究，解决相关的个人和临床因素，以确保他们坚持治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Early Intervention in Psychiatry 医学-精神病学

CiteScore

4.80

自引率

5.00%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.