# Implementation of an Online Mental Health Website for the Early Intervention in Psychosis Services, Developed for the Early Youth Engagement (EYE‐2) Trial: A Cross‐Sectional Survey Study of Clinical Barriers and Facilitators to Normalisation

## TL;DR

This study explores how clinicians in early intervention psychosis services perceive and use an online mental health website, identifying barriers and facilitators to its adoption.

## Contribution

The study applies normalisation process theory to identify specific clinical barriers and facilitators for implementing an online mental health resource in psychosis services.

## Key findings

- Lack of familiarity with the website and its content was a key barrier to its use by clinicians.
- Poorer scores in the 'Collective Action' construct indicated clinicians lacked confidence and skills to integrate the website into sessions.
- The study suggests embedding digital leads and providing training could improve website adoption.

## Abstract

Disengagement is a problem for early intervention in psychosis (EIP) services. Access to trusted information on a website might help to overcome some of the problems associated with disengagement. Clinician and organisational engagement are integral to the implementation and uptake of online resources.

A theory‐driven approach used the normalisation process theory (NPT) to investigate the implementation of an NHS psychoeducational website developed for the Early Youth Engagement Project (EYE‐2). The aim was to establish barriers and facilitators to website use.

A cross‐sectional survey study was used; 36 EIP clinicians in Sussex were asked about their attitudes towards introducing the website and using it in appointments. Accessibility, usability and internet skills were also measured.

A key implementation barrier was lack of familiarity with the website and its content, which inhibited use. Poorer scores in the NPT ‘Collective Action’ construct relating to Skillset Workability and Relational Integration (staff confidence and ability) suggested that clinicians lacked confidence in their skills and ability to introduce the website in clinical sessions. Findings suggest that clinicians, might have lower operational skills compared to the general population.

Embedding of nominated digital leads in teams as well as appropriate training is required to promote familiarity, confidence and enhance digital skills. Larger studies are required to establish the replicability of our findings.