A Scoping Review of Service User Experiences of Potential Harm in Early Intervention in Psychosis Services in the UK

Objectives: Early intervention in psychosis (EIP) services provide care for individuals experiencing first-episode psychosis and are considered both clinically and cost-effective. While many have positive experiences of EIP, there have also been reports of perceived harm. This scoping review synthesised qualitative evidence on service user perspectives of potential harm in EIP services in the UK, to consider how services may continue to improve practice to meet the needs of their patients.Methods: We conducted a scoping review following a pre-registered protocol. Systematic searches were performed in PsycINFO, Web of Science Core Collection, Scopus, Embase, CINAHL Plus, and Medline on 9th October 2024. We included peer-reviewed qualitative studies exploring service user experiences in EIP services in the UK. Data on reported harms from eligible studies were thematically analysed.Results: Twelve studies met inclusion criteria. We identified four main themes: (1) Intersection of stigma and lack of cultural awareness; (2) Inappropriate or inadequate support; (3) Poor relationships and communication; and (4) Challenges in the discharge process.Conclusions: While EIP services offer the current gold standard of care for first episode psychosis, our review highlighted some areas where harm was perceived to have arisen. Such information presents potential targets for service improvement. Strengthening communication, enhancing information sharing, and expanding access to advocacy may help mitigate potential harms and optimise service user experiences. Further research to quantify the prevalence of harms within EIP services is needed to inform best practices and ensure equitable, person-centred care.