BackgroundThere are few evaluations of strategies to improve rates of early
detection and treatment of patients with first-episode psychosisAimsTo evaluate the effectiveness of a general practitioner (GP) education
programme and an early detection assessment team (the Lambeth Early Onset
Crisis Assessment Team; LEO CAT) in reducing delays in accessing
treatment for first-episode psychosis patients.Method46 clusters of GP practices randomised to GP education in early detection
with direct access to LEO CATv. care as usual. Primary
outcome measures were GP referral rates, duration of untreated psychosis
(DUP) and delays in receiving treatment. Results 150
patients with first-episode psychosis were recruited; 113 were registered
with the study GPs, who referred 54 (47.7%) directly to mental health
services. Significantly more intervention group GPs (86.1%
v. 65.7%) referred their patients directly to mental
health services and fewer patients experienced long delays in receiving
treatment. However, their overall DUP was unaffectedConclusionsEducating GPs improves detection and referral rates of first-episode
psychosis patients. An early detection team reduces the long delays in
initial assessment and treatment. However, these only impact on the later
phases of the DUP. Broader measures, such as public health education, are
needed to reduce the earlier delays in DUP.