Evaluating the structure, process and outcome of an early intervention in psychosis program : a case study of the Saskatoon Health Region

Abstract

This study examines, from an administrative perspective, the structures and processes that support positive outcomes in early psychosis. This examination is undertaken by means of a case study across two eras (1991-1998 and 1999-2006) of early intervention in psychosis care in the Saskatoon Health Region, a Canadian health region with a catchment population of about 300,000. This case study was undertaken using a mixed methods approach, including assessments of early intervention clients, a psychiatrist satisfaction survey, a utilization and cost analysis of emergency room and in-patient care, and focus groups of early intervention program stakeholders. In response to the first study question, the study identified two elements of structure that contribute to the effective provision of early intervention services: a diverse inter-professional team and a ”nested” program model. Next, the study identified one element of structure that detracts from the effective provision of early intervention services: staff stress and burn-out. In response to the second study question, the study identified one element of process that contributes to the effective provision of early intervention services: a strong school outreach and programming component. The study also identified one element of process that detracts from the effective provision of early intervention services: co-morbid substance abuse. In response to the third study question, one key administrative outcome was identified: a reduced cost of in-patient hospital care. It is anticipated the results from this study will assist mid-sized health authorities in meeting the needs of low-incidence and complex client groups.