scholarly journals The over-35s: early intervention in psychosis services entering uncharted territory

2018 ◽  
Vol 42 (4) ◽  
pp. 137-140 ◽  
Author(s):  
Felix Clay ◽  
Sophie Allan ◽  
Serena Lai ◽  
Siona Laverty ◽  
Grace Jagger ◽  
...  
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Mental Health Services ◽  
Health Services ◽  
Service Planning ◽  
Clinical Implications ◽  
Mental Health Difficulties ◽  
Early Intervention In Psychosis

Aims and methodFollowing the introduction of new standards for early intervention in psychosis (EIP) in England, EIP services are accepting referrals for people aged 35–65. The Cambridgeshire and Peterborough EIP service (CAMEO) aimed to explore the immediate implications for the service, especially with regards to referral numbers and sources. Data were collected from April 2016 to June 2017.ResultsReferrals for over-35s represented 25.7% of all new referrals. Fifty per cent of referrals for over-35s were accepted onto caseload (40.2% for under-35s). The over-35s were more likely to be referred from acute and secondary mental health services (P < 0.01) and had longer durations of untreated psychosis than the under-35s (P = 0.02).Clinical implicationsCAMEO has received a significantly higher number of referrals as a result of age inclusivity, with an increased proportion of patients suffering from severe, acute psychotic presentations and existing mental health difficulties. This has implications for service planning.Declaration of interestNone.

Early intervention in psychosis in the North Lee Mental Health Services programme: a 5-year review

2019 ◽  
Vol 36 (4) ◽  
pp. 271-277 ◽  
Author(s):  
G. Lalevic ◽  
M. Scriven ◽  
S. O’Brien
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Mental Health Services ◽  
Health Services ◽  
Age Of Onset ◽  
Initial Assessment ◽  
First Episode ◽  
Early Assessment ◽  
The Mean ◽  
Early Intervention In Psychosis

ObjectivesAn Early Intervention in Psychosis (EIP) programme aims to engage patients in early assessment and phase-specific interventions which are the key elements of the Irish National Clinical Programme for psychosis. This study aims to describe and review the EIP programme offered by Cork’s North Lee Mental Health Services over a 5-year period.MethodsA retrospective descriptive study design was adopted to describe and review the EIP programme, patient demographics and treatments offered in the service over a 5-year period.ResultsA total of 139 patients were accepted into the programme over the 5-year period. The mean age of onset was 30 years (median = 28, SD = 9.9), and the mean duration of untreated psychosis was 8 months (median = 2.5, SD = 15.3). Two-thirds of patients were single on initial assessment, had a history of substance misuse and were unemployed. The majority of the cohort engaged with the keyworkers and occupational therapy but did not complete the full psychological or family programmes offered. Hospital admission was required for 12% of the cohort.ConclusionsPatients experiencing their first episode of psychosis can successfully be treated in the community with appropriate professional and family support. However, deficiencies were noted in physical health monitoring, as well as in the availability and engagement with family and psychological therapies. Properly resourced early interventions in psychosis teams are necessary to deliver services at internationally recognised standards.

scholarly journals Help-Seekers in an Early Detection of Psychosis Service: The Non-cases

2021 ◽  
Vol 12 ◽  
Author(s):  
Line Lindhardt ◽  
Morten Lindhardt ◽  
Ulrik Helt Haahr ◽  
Lene Halling Hastrup ◽  
Erik Simonsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Mental Health Services ◽  
Early Detection ◽  
Health Services ◽  
Psychotic Disorder ◽  
Help Seeking ◽  
Psychotic Symptoms ◽  
Early Intervention In Psychosis

Purpose: Enhancing early help-seeking is important for early intervention in psychosis. However, knowledge is limited about those help-seekers who are not initially found to have psychotic symptoms when assessed in services aiming at psychosis detection and, thus, deemed ineligible for early intervention of psychosis programs. We aimed to examine clinical diagnostic and socioeconomic pathways of help-seekers accessing an early detection of psychosis service with referral-free access. Specific focus was on the help-seekers initially assessed not to have psychotic symptoms, considered the non-cases, and to examine potential differences and similarities between non-cases and cases (i.e., those initially assessed to have psychotic symptoms).Methods: We followed 450 help-seekers assessed by a free-of-referral early detection of psychosis team in national registers for up to 4 years. We examined clinical diagnoses and status of not in education, employment, or training (NEET) before and after contact with the team.Results: Of the non-cases, 46% were referred to mental health services by the early detection of psychosis team for evaluation of other mental disorders, and 15% of these were subsequently diagnosed with a non-affective psychotic disorder during follow-up of 12–52 months. Prior to current help-seeking, 39% (n = 174) of the help-seekers had had contact with other mental health services. Nearly a quarter of help-seekers were NEETs at the time of assessment; the number increased during follow-up, both for cases and non-cases. Of the cases, 58% were subsequently clinically diagnosed by mental health services. Those seeking help who had no previous contact with mental health services were more frequently diagnosed with a non-affective psychotic disorder during follow-up (p = 0.05).Conclusion: Referral-free services to promote early detection of psychosis seem a valuable add-on to established pathways, allowing early intervention in psychosis. Our results point to an unmet mental health service need among non-cases; overall, in our sample, independent of case status, social functioning was markedly affected. Our results have implications for future focus in early detection of psychosis. Offering intervention to non-cases within the service has the potential to be cost effective, e.g., if a timely and targeted intervention reduces repeated contacts in other mental health services and social services.

scholarly journals Reducing duration of untreated psychosis: care pathways to early intervention in psychosis services

2013 ◽  
Vol 203 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Max Birchwood ◽  
Charlotte Connor ◽  
Helen Lester ◽  
Paul Patterson ◽  
Nick Freemantle ◽  
...  
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Mental Health Services ◽  
Health Services ◽  
Community Education ◽  
Care Pathway ◽  
Care Pathways ◽  
Duration Of Untreated Psychosis ◽  
Awareness Campaigns ◽  
Early Intervention In Psychosis

BackgroundInterventions to reduce treatment delay in first-episode psychosis have met with mixed results. Systematic reviews highlight the need for greater understanding of delays within the care pathway if successful strategies are to be developed.AimsTo document the care-pathway components of duration of untreated psychosis (DUP) and their link with delays in accessing specialised early intervention services (EIS). To model the likely impact on efforts to reduce DUP of targeted changes in the care pathway.MethodData for 343 individuals from the Birmingham, UK, lead site of the National EDEN cohort study were analysed.ResultsA third of the cohort had a DUP exceeding 6 months. The greatest contribution to DUP for the whole cohort came from delays within mental health services, followed by help-seeking delays. It was found that delay in reaching EIS was strongly correlated with longer DUP.ConclusionsCommunity education and awareness campaigns to reduce DUP may be constrained by later delays within mental health services, especially access to EIS. Our methodology, based on analysis of care pathways, will have international application when devising strategies to reduce DUP.Declarations of interestNone.

scholarly journals Service user, patient, client, user or survivor: describing recipients of mental health services

2010 ◽  
Vol 34 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Peter Simmons ◽  
Chris J. Hawley ◽  
Tim M. Gale ◽  
Thanusha Sivakumaran
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Worker ◽  
Service User ◽  
Rank Order ◽  
Occupational Therapists ◽  
Clinical Implications ◽  
Evidence Based ◽  
Care Community

Aims and methodTo determine which terms receivers of mental health services wish to be known by (service user, patient, client, user, survivor) according to the professional consulted (psychiatrist, nurse, psychologist, social worker, occupational therapist). We conducted a questionnaire study to assess terms by like or dislike and by rank order. There were 336 participants from local catchment area secondary care community and in-patient settings in east Hertfordshire.ResultsPatient is the preferred term when consulted by psychiatrists and nurses, but it is equally preferable to client for social workers and occupational therapists. Service user is disliked more than liked overall, particularly by those who consulted a health professional, but not by those who consulted a social worker. A significant minority wish to be regarded as a survivor or user.Clinical implicationsNational and local mental health services should adopt evidence-based terminology in referring to ‘patient’ or, in some groups, ‘patient or client’ in preference to ‘service user’.

Research watch: what really helps recovery in relation to severe mental health difficulties?

2020 ◽  
Vol 24 (1) ◽  
pp. 6-12
Author(s):  
Sue Holttum
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Design Methodology ◽  
Support Service ◽  
Health Condition ◽  
Service Users ◽  
Content Type ◽  
Inpatient Settings ◽  
Mental Health Difficulties

Purpose The purpose of this paper is to examine three recent papers on mental health services and how they support recovery following a diagnosis of a severe mental health condition. Design/methodology/approach A search was carried out for recent papers on mental health and recovery. The author selected three papers that seemed to advance understanding of not only whether, but also how recovery of a meaningful life may be best supported in mental health services. Findings One paper suggested how staff were able to support service users’ personal goals and focus on recovery in acute inpatient settings, and what got in the way. The author suggests practical ways to address the barriers. A second paper reported the testing of a new model for supporting staff in primary and secondary care to work together so that service users with a diagnosis of bipolar or schizophrenia were better supported to work towards valued goals. A third paper reviewed 40 studies of how people can experience positive change after a first diagnosis of psychosis, and how change happened. Originality/value By studying the issues in detail, all three papers show how improved support for recovery and inclusion can be implemented against the backdrop of many years of service shortcomings.

Developing a Vision for Therapists Working within Child and Adolescent Mental Health Services: Poised or Paused for Action?

2005 ◽  
Vol 68 (4) ◽  
pp. 181-185 ◽  
Author(s):  
Melanie Harrison ◽  
Kirsty Forsyth
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Occupational Therapy ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
The Face ◽  
Therapy Services ◽  
Mental Health Difficulties ◽  
Practice Development

This opinion piece invites a professional debate on the organisation of Child and Adolescent Mental Health Services (CAMHS) occupational therapy in order to deliver the modernisation agenda while sustaining its excellent record for practice development and innovation. In the face of such challenges, there needs to be reflection on whether CAMHS occupational therapy is ‘poised’ or ‘paused’ for action and what strategies would tackle existing challenges and support its growth. The piece puts forward a potential vision involving occupation-focused theory and developing academic and practice partnerships in order to ensure that children with mental health difficulties access occupation-focused, theory-driven and evidence-based occupational therapy services.

Identification of Prodromal Signs and Symptoms and Early Intervention in Manic Depressive Psychosis Patients: A Case Example

1995 ◽  
Vol 23 (4) ◽  
pp. 399-409 ◽  
Author(s):  
Alison Perry ◽  
Nicholas Tarrier ◽  
Richard Morriss
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Mental Health Services ◽  
Health Services ◽  
Signs And Symptoms ◽  
Pharmacological Intervention ◽  
Psychotic Symptoms ◽  
Prodromal Phase ◽  
Manic Depressive Psychosis ◽  
Manic Depressive

Recent research has revealed that relapse in manic depressive psychosis and schizophrenia is preceded by specific prodromal signs and symptoms that include dysphoria, other non-psychotic symptoms and features unique to individual patients. Treatment studies in schizophrenia have shown that early pharmacological intervention during a prodromal phase of psychotic relapse may be effective in the prevention of hospitalization. This paper describes the procedure of prodromal signs identification in manic depressive psychosis and the negotiation of an appropriate plan of action with the mental health services in order to abort the relapse or reduce its severity through early pharmacological intervention. A case example is presented to demonstrate this approach.

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