Barriers and Opportunities for Collaboration With Primary Care: Perspectives of Early Psychosis Intervention Programs in Ontario, Canada
Bibliographic record
Abstract
BACKGROUND: Collaboration between early psychosis intervention (EPI) services and primary care is crucial for continuity of care for first-episode psychosis. The aim of this study was to describe the perceptions of staff at EPI programs on barriers and opportunities for collaboration with primary care. METHODS: We conducted a qualitative descriptive study using focus groups with staff at six EPI programs across Ontario, Canada (2 rural, 4 urban) with 2-9 participants per focus group (total n = 39). Focus group sessions were audio recorded and transcribed verbatim. We used thematic analyses to code the transcripts and identify emergent themes. RESULTS: Participants highlighted three points in the EPI treatment process where collaboration with primary care is important: during the referral/intake process, shared care throughout treatment, and at discharge from the EPI program. We identified four themes relating to broader structural issues impacting collaboration with primary care through the treatment process: client access to primary care, family physician knowledge of early psychosis, siloed communication structures, and time constraints for both EPI staff and family physicians. CONCLUSIONS: Improving primary care access in young people, increasing family physician knowledge of psychosis and EPI services, and allowing dedicated time for communication for both family physicians and EPI clinicians may improve collaboration and patient care through the processes of intake, ongoing care, and discharge from EPI services.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.027 | 0.007 |
| Scholarly communication | 0.005 | 0.001 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".