Marianne Melau1, Nikolai Albert1, Merete Nordentoft1; 1Mental Health Centre Copenhagen, Copenhagen University Hospital, Denmark
The evidence-based Specialized Early Intervention (SEI) has in Denmark grown to be a nationwide service for young adults’ experiencing a first episode psychosis. The implementation of the program was carried out without the use of fidelity measures. To rectify this, we developed and tested out a Danish fidelity scale for SEI teams, and for the first time we did a nationwide assessment of the quality and program fidelity of the SEI teams in Denmark. We found the fidelity scale to be a feasible and easy manageable tool for collecting fidelity data, and by using a multimodal approach we got a good understanding of how multidisciplinary teams interact and manage various aspects of a patient's treatment. Totally 96% (n = 22) of the SEI teams participated and all in all 59 % (n = 13) fulfilled the criteria for program fidelity in a satisfactory level. We found that there was high variability between SEI teams according to the structural domain of the fidelity scale. By contrast, we found great homogeneity between the teams in terms of item referring to treatment. This mapping of SEI teams’ program fidelity in Denmark makes it obvious that at a national level, there is an urgent need for a more systematic approach to training and supervision, with a centralized development of educational material, provision of training and organization of supervision. The study revealed a fragile organization of the educational activities. Models for implementation of continuous fidelity measurements will be discussed.
