{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:24:52Z","timestamp":1790630692076,"version":"4.1.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100018270","name":"Health Service Executive","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018270","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychiatry"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Early intervention in psychosis (EIP) supports people who are experiencing their first episode of psychosis (FEP). A new Model of Care (MoC) for EIP services was launched in Ireland in 2019. Three EIP demonstration sites were chosen to test this MoC through a \u2018hub and spoke\u2019 approach. These services were a new way of organising care for people experiencing FEP, based upon a recovery model of care, and which sought to standardise care, improve access by clinically led multidisciplinary teams. This included newly created EIP keyworker roles whereby keyworkers assumed responsibilities regarding assessment, comprehensive individual care planning and coordination of care.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A mixed methods design utilising the UK Medical Research Council\u2019s process evaluation framework. Purposive sampling techniques were utilised. Descriptive analyses and logistic regression were performed to examine how increased keyworker engagement influenced the use of other psychosocial interventions within the EIP demonstration sites. Thematic analyses was used for qualitative data.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There was a strong positive relationship between keyworker contacts and psychosocial interventions offered. Specifically, the odds of achieving at least monthly engagement with cognitive behavioural therapy for psychosis (CBTp; (5.76 (2.43\u201313.64), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and behavioural family therapy (BFT; (5.52(1.63\u201318.69, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.006)) increased by fivefold with each additional monthly keyworker contact. For individual placement support (IPS) each additional monthly keyworker contact was associated with a three-fold increase in the odds of achieving monthly attendance with IPS (3.73 (1.64\u20138.48), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.002). Qualitative results found that the EIP keyworker role as viewed by both service users and staff as a valuable nodal point, with a particular emphasis on care coordination and effective communication.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study advances the understanding of keyworker effects through qualitative evidence of keyworkers functioning as a \u201clinchpin\u201d to the service, while the positive response association between keyworker contacts and engagement with other services provides quantitative support for keyworkers reducing the organisational or structural barriers to service access. Given the importance of these positions, health systems should ensure that EIP programmes identify qualified and experienced staff to fill these roles, as well as allocate the appropriate funding and protected time to support keyworker engagement and impact.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12888-024-05577-7","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T12:03:39Z","timestamp":1707134619000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Monthly engagement with EIP keyworkers was associated with a five-fold increase in the odds of engagement with psychosocial interventions"],"prefix":"10.1186","volume":"24","author":[{"given":"C. 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Early intervention for psychosis. Schizophr Bull. 2011;37(6):1111\u20134.","journal-title":"Schizophr Bull"},{"key":"5577_CR2","unstructured":"Department of Health. The Mental Health Policy Implementation Guide [Internet]. London, United Kingdom: Department of Health; 2001 [cited 2022 Oct 19]. Available from: Department of Health. (2001). The Mental Health Policy Implementation Guide. London: Department of Health."},{"key":"5577_CR3","unstructured":"Ministry of Health and Long-Term Care. Early Psychosis Intervention Program Standards [Internet]. Ontario, Canada: Ministry of Health and Long-Term Care; 2011 [cited 2022 Oct 19]. Available from: https:\/\/www.health.gov.on.ca\/english\/providers\/pub\/mental\/epi_program_standards.pdf."},{"issue":"5","key":"5577_CR4","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1097\/NMD.0000000000000284","volume":"203","author":"PD McGorry","year":"2015","unstructured":"McGorry PD. Early intervention in psychosis. 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All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from each individual participant for the qualitative interviews. Permission for use of the quantitative data was provided by the clinical leads in the services.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"CD, GN, NOC, HR report no competing interests. KOC and RJ both have roles within the HSE. KOC is the National Clinical Lead for Early Intervention in Psychosis. RJ is the Programme Manager Mental Health within the Mental Health National Clinical Programmes. KOC and RJ were not involved in any element of study design, data collection or data analysis, but as EIP service providers they contributed to the writing and review of this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"96"}}