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Early Interv Psychiatry. 2017 Aug 23. doi: 10.1111/eip.12470. [Epub ahead of print]

Investigating service features to sustain engagement in early intervention mental health services.

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Department of Psychology, Neuroscience & Behaviour (PNB), McMaster University, Hamilton, Ontario, Canada.
Department of Psychiatry & Behavioural Neurosciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
McMaster Children's Hospital, Hamilton, Ontario, Canada.
Mental Health and Addiction Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.



To understand what service features would sustain patient engagement in early intervention mental health treatment.


Mental health patients, family members of individuals with mental illness and mental health professionals completed a survey consisting of 18 choice tasks that involved 14 different service attributes. Preferences were ascertained using importance and utility scores. Latent class analysis revealed segments characterized by distinct preferences. Simulations were carried out to estimate utilization of hypothetical clinical services.


Overall, 333 patients and family members and 183 professionals (N = 516) participated. Respondents were distributed between a Professional segment (53%) and a Patient segment (47%) that differed in a number of their preferences including for appointment times, individual vs group sessions and mode of after-hours support. Members of both segments shared preferences for many of the service attributes including having crisis support available 24 h per day, having a choice of different treatment modalities, being offered help for substance use problems and having a focus on improving symptoms rather than functioning. Simulations predicted that 60% of the Patient segment thought patients would remain engaged with a Hospital service, while 69% of the Professional segment thought patients would be most likely to remain engaged with an E-Health service.


Patients, family members and professionals shared a number of preferences about what service characteristics will optimize patient engagement in early intervention services but diverged on others. Providing effective crisis support as well as a range of treatment options should be prioritized in the future design of early intervention services.


discrete choice experiment; early medical intervention; mental health services (services, mental health); patient participation (patient engagement); patient preference (patient satisfaction)


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