scholarly journals The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England

2018 ◽  
Vol 27 (11) ◽  
pp. 1772-1787 ◽  
Author(s):  
Anika Reichert ◽  
Rowena Jacobs
Keyword(s):  
Early Intervention ◽  
Patient Outcomes ◽  
Waiting Time ◽  
Early Intervention In Psychosis ◽  
The Impact

scholarly journals Improving access to Early Intervention in Psychosis (EIP): the 2-week wait for cancer comes to psychosis

2018 ◽  
Vol 7 (3) ◽  
pp. e000190
Author(s):  
Kirit Singh ◽  
Fatima Ghazi ◽  
Rebecca White ◽  
Benedicta Sarfo-Adu ◽  
Peter Carter
Keyword(s):  
Early Intervention ◽  
Previous Treatment ◽  
Negative Effects ◽  
Eligibility Criteria ◽  
North East ◽  
The North ◽  
Allocation Process ◽  
Case Allocation ◽  
Early Intervention In Psychosis ◽  
The Impact

Early Intervention in Psychosis (EIP) services aim to rapidly initiate specialist packages of care for those people newly experiencing symptoms. The intention of such rapid engagement is to mitigate the negative effects of a prolonged duration of untreated psychosis. Aiming to achieve a ‘parity of esteem’ between mental and physical health, a new target was introduced by the National Health Service (NHS) England, where 50% of new referrals were expected to receive a concordant package of care within 2 weeks from the National Institute for Health and Care Excellence. A baseline assessment in late 2014 found that just 21% of all referrals received and accepted met this target within the EIP Team for the North-East London NHS Foundation Trust. This project sought to improve the team’s performance, seeking input from all team members and using an iterative process with the primary aim of meeting the target ahead of its roll-out. It was determined that the relatively high number of inappropriate referrals (34% at baseline) is a key causative agent in delaying staff from processing eligible cases in a timely fashion. These are defined as referrals which do not meet basic eligibility criteria such as no previous treatment for psychosis. Interventions were therefore designed targeting three domains of improving staff awareness of the new target, improving efficiency by changing the case allocation process and improving the referral pathway for external sources. The impact of these changes was re-evaluated over two cycles beyond baseline. By the final cycle, 62% of new referrals were seen within 2 weeks, while inappropriate referrals declined to just 3%. The multi-interventional nature of this project limits its generalisability and further work should be carried out to identify those changes that were most impactful. Nevertheless, focused targeting of the referral pathway may prove to be of benefit to other EIP services struggling with lengthy wait times.

Exploring the impact of peer support in early intervention in psychosis

2017 ◽  
Vol 21 (2) ◽  
pp. 102-109
Author(s):  
Hannah White ◽  
Laura Price ◽  
Tom Barker
Keyword(s):  
Early Intervention ◽  
Peer Support ◽  
Qualitative Methodology ◽  
Service Providers ◽  
Service Users ◽  
Content Type ◽  
Service Engagement ◽  
Mental Health Settings ◽  
Early Intervention In Psychosis ◽  
The Impact

Purpose Peer support (PS) has, over recent years, been implemented across a variety of NHS adult mental health settings. In November 2015, peer support workers (PSW) were introduced to an Early Intervention in Psychosis Service (EIS) in the Midlands. The purpose of this paper is to focus on organisational factors, asking how do PS impact on an early intervention in psychosis multi-disciplinary team (MDT). Design/methodology/approach Six EIS MDT members participated in an hour-long focus group. The data were analysed using thematic analysis, in line with a qualitative methodology (Braun and Clarke, 2006). Findings Two themes were generated, including “The values of PS” (consisting of three sub-themes: improving service engagement; personal qualities; and the peer relationship); and “The peer support role” (consisting of three sub-themes: living experience; boundaries; and alternative perspectives). Findings imply that PS in the current EIS related to: improved service engagement and greater understanding between service providers and users; which could be linked to better outcomes for service users (such as reduced duration of untreated psychosis (DUP)). Originality/value It has been suggested that PSWs facilitate an improved understanding between service providers and service users (Repper and Watson, 2012). However, research into organisational and team benefits of PS is lacking, with a need for more exploration (Repper, 2013). The current study begins to address the lack of literature regarding the organisational impact of PS, and even further regarding early intervention.

scholarly journals Access and Waiting Time Standard for Early Intervention in Psychosis: At Risk Mental State Identification and Interventions Accepted within a Routine Service

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Vidyah Adamson
Keyword(s):  
At Risk ◽  
Early Intervention ◽  
Waiting Time ◽  
Mental State ◽  
Psychotic Symptoms ◽  
Service Users ◽  
Routine Service ◽  
Time Standard ◽  
Early Intervention In Psychosis ◽  
At Risk Mental State

Aim: Following the introduction of an access and waiting time standard for Early Intervention in Psychosis (EIP) services, the identification and treatment of people experiencing an At-Risk Mental State (ARMS) for psychosis has become a national priority. However, there is a dearth of literature concerning what is offered to and accepted by ARMS service users within routine services. Methods: This descriptive evaluation reports upon the assessment and treatment of people with an at-risk mental state identified during the first year of a routine service operating in line with the EIP standard. The paper details referral sources, referral to treatment times, socio-demographic characteristics, ARMS subgroups and the interventions accepted by these service users. Results: A total of 138 ARMS cases were identified over the evaluation period, with 73% (n=101) aged between 18-34 years and 86% (n=118) meeting attenuated psychotic symptoms criteria. The majority (64%) of service users engaged in multiple interventions; 54% (n=75) accepted psychoeducation and coping skills enhancement work, 42% (n=58) participated in a sleep programme, 33% (n=45) undertook coping with voices and visions work and 28% (n=39) engaged in individual psychological therapy. Conclusion: The findings indicate that the majority of ARMS service users presenting to the EIP service were aged 18-34 and experienced attenuated psychotic symptoms. A range of NICE and CBT informed interventions as well as individual psychological therapies appear to be acceptable to ARMS service users and many engaged in multiple interventions offered.

scholarly journals The impact of COVID ‐19 on an early intervention in psychosis service

2020 ◽  
Vol 24 (4) ◽  
pp. 17-21
Author(s):  
Nandini Chakraborty ◽  
Richard Carr ◽  
Samuel Tromans
Keyword(s):  
Early Intervention ◽  
Early Intervention In Psychosis ◽  
The Impact

scholarly journals TF-CBT and EMDR for young people with trauma and first episode psychosis (using a phasic treatment approach): two early intervention service case studies

2018 ◽  
Vol 11 ◽  
Author(s):  
Joanna Ward-Brown ◽  
David Keane ◽  
Gita Bhutani ◽  
Debbie Malkin ◽  
Bill Sellwood ◽  
...  
Keyword(s):  
Early Intervention ◽  
Case Studies ◽  
Traumatic Stress ◽  
Psychological Therapy ◽  
First Episode ◽  
Post Traumatic Stress ◽  
Co Morbidity ◽  
Post Traumatic ◽  
Early Intervention In Psychosis ◽  
The Impact

AbstractThe relationship between trauma and psychosis is well established with a large amount of overlap between the ICD/DSM (International Classification of Diseases/Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria for post-traumatic stress disorder (PTSD) and psychosis and/or schizophrenia. In spite of co-morbidity and evidence of the links and underlying mechanisms, trauma is rarely a focus of intervention in psychosis. Psychosis has often been on the list of exclusion criteria for PTSD research studies. There is a lack of literature on the impact of trauma work with people experiencing psychosis. The National Institute for Health and Care Excellence (NICE) (2014) suggests that Early Intervention in Psychosis (EIP) service users should be assessed for PTSD, and PTSD guidelines (NICE, 2005) followed for those who show signs of post-traumatic stress. There is a need to evaluate the effectiveness of therapeutic approaches for people with PTSD and co-morbid psychosis. These case studies aim to provide initial evidence of how two EIP clients experienced and responded to NICE-recommended psychological therapy for trauma. This study aims to test the feasibility of trauma work delivered via a phasic approach in a novel population. Two EIP clients received psychological therapy [including trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitization and reprocessing (EMDR)] for identified traumatic experiences. Assessment outcome measures were utilized to establish the effectiveness of the interventions. Both clients reported significant improvements following therapy, including reduced trauma-related distress, reduced distress from symptoms of psychosis and improved quality of life. Clients with co-morbid PTSD and symptoms of psychosis are likely to benefit from recommended psychological treatments for PTSD. Further research is required to address generalizability to a larger population.

Lessons from an aborted controlled trial on the impact of befriending in an early intervention in psychosis population

2021 ◽  
Author(s):  
Lars Hansen ◽  
Emma Bayford ◽  
Rachael Wood ◽  
Katherine Newman‐Taylor ◽  
Kyt Proctor ◽  
...  
Keyword(s):  
Early Intervention ◽  
Controlled Trial ◽  
Early Intervention In Psychosis ◽  
The Impact
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