Factors of Engagement in Employment or Education Following a First Episode of Psychosis: A Systematic Review and Narrative Synthesis

Abstract

Despite 75% of people who experience a first episode of psychosis (FEP) reaching clinical remission, this population continue to face lower rates of vocational recovery. This review aimed to identify the factors which help and hinder individuals' employment and post-secondary education engagement post-FEP. Three electronic databases (Psych INFO, Medline and Social Science Database) were searched up to 21st August 2023. Primary research on employment/education status or engagement within FEP populations ages 18–40 were included. A narrative synthesis was applied to the findings. Of the 10,575 articles screened, 18 were included in the final review. Younger age, non-affective psychotic diagnoses and stigma were identified as common barriers to engagement. Ceasing substance use and having family/financial support were reported as facilitators. Conflicting findings were reported as to the impact of positive and negative symptoms. The range of factors emerging from this review highlight several potential barriers and facilitators for individuals seeking employment or further education opportunities post-FEP. This underlines the need for further research into how and why they influence employment and educational outcomes, with a view to improving treatment outcomes by incorporating these factors into care planning.