Psychosis affects 1-2% of the population. People with psychosis tend to perceive and interpret events differently from those around them, and are often socially withdrawn. Psychosis can last for decades and cause much distress to patients and carers. In the NHS, these patients receive medication, practical support and sometimes talking therapies. Yet, these treatments have limited benefit, and many patients remain socially isolated. This can lead to a further decline in health with more hospital stays and poor quality of life.
 
The proposed research will try an approach that is different from what health services currently do. In studies in other countries, services have helped patients to expand their social network through activities, such as hobbies, that involve meeting and communicating with other people. These initiatives have been successful. We will now see whether we can help patients in the NHS in a similar way. For this, we propose several research studies, involving patients and different health professionals throughout the process. In the planned intervention, a health professional will discuss with a patient how many people they meet and possibilities to meet new people. The two will agree on some new activities and have further meetings over a six month period for more discussions and support. The idea is that patients will expand their social networks and through this have a better quality of life, fewer symptoms and will be more able to avoid mental health crises.
 
The research will interview patients in different parts of the country to find out what their social contacts  are, how they can meet new people, and how the internet might be used to support this. We will also discuss with patients and health professionals how to refine the intervention so that patients will accept it and benefit from it. We will then test the intervention with 24 patients to see how it works. Based on the findings we will revise the approach, and then ask more than 500 patients across different locations in England to participate in a larger study testing whether the new approach does actually improve patients’ quality of life and mental health.
 
During the study all patients will continue with their normal care. In addition, some will receive the intervention to expand their social networks, mainly through engaging in activities that require personal contacts with new people. The other patients will not receive it. After 6, 12 and 18 months, we will interview all patients. We will then compare quality of life, mental health and treatment costs in the two groups and test the effectiveness and cost effectiveness of the intervention. Finally, we will see how the intervention can be best implemented in the NHS and work with patients and professional groups to share our findings widely.