Exploring the experiences and understandings of psychosis through relationships with family members, mental health services, and society

This thesis includes three sections: a literature review, an empirical paper, and a critical appraisal of the thesis. Early Intervention Services (EIS) are specialist mental health services for people who are experiencing a ‘first episode of psychosis’. EIS are a widely adopted approach in England and internationally. Previous qualitative research exploring people’s experiences of accessing EIS was reviewed through a process of meta-ethnography. Eleven qualitative articles were included in this review; the findings of these studies were analysed and synthesised. Four major themes were developed: Understanding through relationships; Recovery and hope; Sense of self; and Medication. Recommendations for clinical practice and future research were made. There is a widespread narrative in most Westernised societies that mental health difficulties ‘run in families’. One account of this attributes familial mental health difficulties to environmental or psychosocial factors, the other leading account links mental health difficulties to biogenetic factors. This study was interested in how these two accounts impact on people who have a parent with experiences of mental health difficulties. I interviewed four people who had a biological parent with experiences of ‘psychosis’ or a diagnosis of ‘schizophrenia’. The interviews were analysed using Interpretative Phenomenological Analysis. Four super-ordinate themes were developed: The Fear; Signs of (in)sanity - navigating my own mental health; ‘Who is my mum?’ - multiple and evolving identities, relationships, and (re)connection; (4) ‘A caregiver for your caregiver’ - multiple family roles and responsibilities. Clinical and research implications were discussed. The critical appraisal explored: my own inspirations for conducting the empirical paper; how the empirical paper influenced my own practice; and controversies and issues surrounding the biomedical model and its impact on families. Methodological challenges associated with this research were also discussed.

Name dc:type.qualificationname

Ph.D.

Level dc:type.qualificationlevel

doctoral

Grantor dc:publisher.institution

Lancaster University

Year dc:date.issued

2018

Authors dc:creator

• Homberger, Maximilian
• Hodge, Suzanne
• Reid, Graeme