{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:49:51Z","timestamp":1789487391888,"version":"build-2803163510"},"reference-count":33,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"MQ Mental Health Research","award":["MPSIP\\33"],"award-info":[{"award-number":["MPSIP\\33"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,17]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Engagement with mental health services during first-episode psychosis is critical for symptom control, quality of life and relapse prevention. However, disengagement rates remain high in Uganda, with severe consequences for patients and caregivers. This study protocol describes a mixed-methods investigation that aims to examine the relationship between patient and caregiver lived experiences and mental health service engagement during first-episode psychosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The mixed-methods study will recruit 82 patients with first-episode psychosis and their primary caregivers from Butabika National Referral Mental Hospital in Kampala, Uganda. Inclusion criteria are being aged 18\u201360 years, having received antipsychotic medication for fewer than 12 weeks and living in the Greater Kampala Metropolitan Area, with a consenting caregiver. Caregivers must be adults (aged \u226518 years) providing full-time care for at least 6\u2009months prior to enrolment. Patients with substance use disorders will be excluded. Qualitative data on the lived experiences of patients and caregivers will be collected using the draw-write-and-tell method, while quantitative data on service engagement and associated factors will be collected using semistructured questionnaires. The quantitative component is exploratory and is intended to identify candidate predictors of engagement for testing in future adequately powered studies. The data will be analysed using Stata V.18, and participants will be reimbursed for their time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical clearance has been obtained from the School of Medicine Research and Ethics Committee (SOMREC) (reference: Mak-SOMREC-2024-1002) of Makerere University and institutional approval from Butabika National Referral Mental Hospital. All participants will provide informed consent prior to participation. Data will be de-identified and securely stored, with results disseminated through peer-reviewed academic publications, conferences and community stakeholder workshops.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121910","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:01:44Z","timestamp":1789480904000},"page":"e121910","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Patient and caregiver lived experiences and mental health service engagement during first-episode psychosis in Uganda: a longitudinal mixed-methods study protocol"],"prefix":"10.1136","volume":"16","author":[{"given":"Prisca","family":"Oroma","sequence":"first","affiliation":[{"name":"Specialised Treatment Early in Psychosis Services, Makerere University Hospital, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0060-0842","authenticated-orcid":false,"given":"Andrew Sentoogo","family":"Ssemata","sequence":"additional","affiliation":[{"name":"Specialised Treatment Early in Psychosis Services, Makerere University Hospital, Kampala, Central Region, Uganda"},{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe, Central Region, Uganda"},{"name":"International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK"},{"name":"Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilber","family":"Ssembajjwe","sequence":"additional","affiliation":[{"name":"Specialised Treatment Early in Psychosis Services, Makerere University Hospital, Kampala, Central Region, Uganda"},{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Auma","sequence":"additional","affiliation":[{"name":"Heart to Heart Spaces, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Balinga","sequence":"additional","affiliation":[{"name":"Specialised Treatment Early in Psychosis Services, Makerere University Hospital, Kampala, Central Region, Uganda"},{"name":"Butabika National Referral Mental Hospital, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blessed Tabitha","family":"Aujo","sequence":"additional","affiliation":[{"name":"Specialised Treatment Early in Psychosis Services, Makerere University Hospital, Kampala, Central Region, Uganda"},{"name":"Department of Mental Health, Soroti Regional Referral Hospital, Soroti, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Kaggwa","family":"Kaddu","sequence":"additional","affiliation":[{"name":"Specialised Treatment Early in Psychosis Services, Makerere University Hospital, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Ampiire","sequence":"additional","affiliation":[{"name":"Specialised Treatment Early in Psychosis Services, Makerere University Hospital, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson Winstons","family":"Muhwezi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel Kiiza","family":"Mwesiga","sequence":"additional","affiliation":[{"name":"Specialised Treatment Early in Psychosis Services, Makerere University Hospital, Kampala, Central Region, Uganda"},{"name":"Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etheldreda Mpungu","family":"Nakimuli","sequence":"additional","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe, Central Region, Uganda"},{"name":"Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Central Region, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"2026091507010421000_16.9.e121910.1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2017.17050480"},{"key":"2026091507010421000_16.9.e121910.2","doi-asserted-by":"crossref","unstructured":"Mwesiga EK , Nakasujja N , Ongeri L , et al . 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