Experiences and lessons from the Singapore Early Psychosis Intervention Programme

2019 ◽  
pp. 101-108
Author(s):  
Swapna K. Verma ◽  
Poon Lye Yin ◽  
Helen Lee ◽  
Chong Siow Ann
Keyword(s):  
Mental Health ◽  
Public Awareness ◽  
Health Assessment ◽  
Mental Healthcare ◽  
Early Psychosis ◽  
First Episode ◽  
Intervention Programme ◽  
Long Duration ◽  
National Mental Health ◽  
Specific Care

The long duration of untreated psychosis (DUP) and probable severe consequences were the impetus for establishing the Early Psychosis Intervention Programme (EPIP) in Singapore in the year 2001. EPIP is a comprehensive, integrated, patient-centred programme which aims to improve the outcome of patients with first-episode psychosis through public awareness and destigmatization initiatives, collaboration with community services, and provision of early engagement and phase-specific care of those with psychosis. In April 2007, the Singapore Ministry of Health launched its first ever National Mental Health Blueprint, and several community-based services were developed to improve mental healthcare and strengthen early detection and prevention of mental illnesses. The Blueprint thus provided the opportunity for the EPIP to strengthen its early intervention efforts beyond psychosis. This chapter discusses the role of the Community Health Assessment Team (CHAT) which is more broad-based, focusing on promoting awareness of youth mental health issues and encouraging this sector of the population to seek help early.

scholarly journals Loneliness in early psychosis: A qualitative study exploring the views of mental health practitioners in early intervention services

2020 ◽  
Author(s):  
Theodora Stefanidou ◽  
Jingyi Wang ◽  
Nicola Morant ◽  
Brynmor Lloyd-Evans ◽  
Sonia Johnson
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Public Health Problem ◽  
Early Psychosis ◽  
Mental Health Practitioners ◽  
First Episode ◽  
Physical And Mental Health ◽  
Early Intervention Services ◽  
Health Practitioners ◽  
Intervention Services

Abstract Background: Loneliness is an important public health problem with established adverse effects on physical and mental health. Although, people with psychosis often experience high levels of loneliness, relatively little is known about the relationship between loneliness and early psychosis. Potential interventions to address loneliness might be easier to implement early in the illness when social networks and social skills may be more intact than at a later stage. We investigated the views of mental health practitioners about the context and causes of loneliness in people with early psychosis, and about potential interventions.Methods: Semi-structured face-to-face interviews were conducted with mental health practitioners (n=20). Participants were purposively recruited from four early intervention services for first-episode psychosis in the UK. Interviews were transcribed verbatim and thematic analysis was conducted.Results: Participants believed that the majority of service users with early psychosis experience feelings of loneliness. They often saw socially isolated and disconnected clients and believed them to be lonely, but rarely discussed loneliness explicitly in clinical interactions. A combination of symptoms, stigma and negative sense of self were believed to underpin loneliness. Participants could not identify any specific current interventions delivered by their services for tackling loneliness, but thought some routinely provided interventions, including social groups and psychological treatments, could be helpful. They favoured making a wider range of loneliness interventions available and believed that community agencies beyond mental health services should be involved to make these effective and feasible to deliver. They suggested social participation interventions without an explicit mental health focus as potentially promising and valued a co-produced approach to intervention development. Conclusions: This study suggests that loneliness is not routinely discussed in early intervention services, and a targeted strategy for tackling it is lacking. Co-produced, individualised community approaches, and interventions that target symptoms, stigma and negative self-schemas might be beneficial in alleviating loneliness for people with early psychosis. Empirical research is needed to develop and test such interventions.

scholarly journals Mental health services in Cambodia: an overview

2019 ◽  
Vol 17 (2) ◽  
pp. 29-31
Author(s):  
Sarah J. Parry ◽  
Ewan Wilkinson
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Rapid Growth ◽  
Urban Areas ◽  
Mental Healthcare ◽  
Mental Health Training ◽  
Health Strategy ◽  
Professional Mental Health ◽  
National Mental Health

Mental health services in Cambodia required rebuilding in their entirety after their destruction during conflict in the 1970s. During the late 1990s there was rapid growth and development of professional mental health training and education. Currently, basic mental healthcare is available primarily in urban areas and is provided by a mixture of government, non-government and private services. Despite the initial rapid growth of services and the development of a national mental health strategy in 2010, significant challenges remain in achieving an acceptable, standardised level of mental healthcare nationally.

Hard routes of mental health in Portugal: what can we offer to an adolescent with serious mental illness and multiple social risk factors?

2020 ◽  
Vol 13 (4) ◽  
pp. e229120
Author(s):  
Rita Goncalves ◽  
Mafalda Marques ◽  
Teresa Cartaxo ◽  
Vera Santos
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Best Practice ◽  
Mental Health Problems ◽  
Psychiatric Patients ◽  
Mental Healthcare ◽  
Developed Countries ◽  
First Episode ◽  
Social Risk ◽  
Social Risk Factors

Worldwide, millions of children and adolescents are suffering due to a lack of efficient mental healthcare. Although some progress has been made to address the mental health problems in this age group, currently, even developed countries fail in providing psychiatric patients with the best practice care. We present a case of a Portuguese adolescent with a first episode of psychosis in whom multiple social and environmental risk factors were identified as triggers to his clinical presentation, as well as fundamental determinants of prognosis in the short and long term. In this case, we demonstrate how social determinants, including poverty, family dysfunction and difficulties in accessing appropriate mental healthcare, strongly influence the development, maintenance and prognosis in early psychosis during adolescence. Furthermore, we consider the implications of an absence of community-based mental healthcare and rehabilitation services and reasons for why this may complicate the management and limit opportunities to this patient population.

The Nature of Schizophrenia: Signposts to Prevention

2000 ◽  
Vol 34 (1_suppl) ◽  
pp. A14-A21 ◽  
Author(s):  
Patrick D. McGorry
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Primary Prevention ◽  
Psychotic Disorders ◽  
Early Years ◽  
First Episode ◽  
Preventive Interventions ◽  
Work Settings ◽  
The Face ◽  
National Mental Health

Objective To describe the characteristics of schizophrenia relevant to conducting indicated preventive interventions. Method A systematic review of the literature informed by experiences at the Personal Assistance and Crisis Evaluation (PACE) clinic. Results Primary prevention requires a sophisticated knowledge of key causal risk factors relevant to the expression of a disorder. The causal risk factors most useful from an intervention standpoint may turn out to be somewhat removed from the neurobiology of the disorder and may even be relatively non-specific, so that tackling them could reduce the risks for a range of mental disorders. The frontier for more specific prevention in schizophrenia and related psychosis is currently represented by indicated preventive interventions for subthreshold symptoms. Again, these may be relatively broad spectrum early in the prepsychotic phase but more proximal to onset, greater treatment specificity can be explored. However, this can be viewed more as preventively orientated treatment rather than primary prevention per se. Early detection of first episode psychosis and optimal intensive treatment of first episodes and the critical early years after diagnosis also represent increasingly attractive preventive foci in psychotic disorders. Conclusion As evidence accumulates, implementation of evidence-based practice in real work settings is a major challenge as it is throughout the mental health service system. The momentum of preventively orientated treatment must be maintained through the 2nd National Mental Health Strategy and in the face of recent misleading polemic regarding the treatability of psychotic disorders, especially schizophrenia. The evidence demonstrates that schizophrenia and related disorders have never been more treatable.

India is going partway to easing mental health crisis

2019 ◽  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Mental Healthcare ◽  
Mental Health Crisis ◽  
Indian Government ◽  
Health Crisis ◽  
Content Type ◽  
Tertiary Healthcare ◽  
The Government ◽  
National Mental Health

Subject India's efforts to address a mental health crisis. Significance The Indian government is aiming to convert 150,000 primary health centres into health and wellness centres (HWCs) providing comprehensive care, including management of mental disorders. Its plans for secondary and tertiary healthcare include medical insurance for poorer families that will cover treatment of mental illness. According to a 2016 study conducted by India’s National Institute of Mental Health and Neurosciences (NIMHANS), 150 million out of the country’s 1.3 billion people urgently need mental healthcare. Impacts Expanding mental healthcare infrastructure could lead to an overemphasis on a biomedical model of treatment for mental health disorders. The government will come under pressure to increase funding for mental health professionals as well as technological resources. Future budgets will be key indicators of the government’s commitment to its National Mental Health Programme.

A pilot early psychosis intervention programme in Bolivia

2016 ◽  
Vol 33 (S1) ◽  
pp. S585-S585
Author(s):  
G. Rivera Arroyo
Keyword(s):  
Intervention Program ◽  
Multidisciplinary Treatment ◽  
Time Frame ◽  
Early Psychosis ◽  
First Episode ◽  
Treatment Team ◽  
Santa Cruz ◽  
Long Term Outcomes ◽  
Intervention Programme

The problemLess than half of the more than 250 adolescents and young adults who are estimated to experience a first episode of psychosis in the city of Santa Cruz each year are ever diagnosed and receive treatment.Of those patients who are eventually diagnosed, the average duration of their symptoms of psychosis prior to receiving treatment is estimated to be over 2 years.The opportunityMultiple psychosocial variables, such as the reaction of patients and their families to symptoms of psychosis, which play a vital role in determining long-term outcomes, demonstrate their highest degree of flexibility during the period of early psychosis. Psychological, social and evidence-based pharmacological interventions undertaken during this time frame can have a profound impact on the life-course of an individual with psychosis.Our solutionWe propose to establish a pilot early psychosis intervention program that will provide age appropriate biopsychosocial treatment and support for 15–25 years old with first episode psychosis and their families in Santa Cruz. This will improve short and long-term outcomes for those with psychosis, increase speed of recovery, decrease the need for hospitalization, reduce family disruption and decrease rates of relapse.By utilizing a mobile, multidisciplinary treatment team that emphasizes the roles of trained case managers focused on providing intensive individual and family support in the home, this program will provide culturally appropriate care that will leverage contributions from a limited supply of psychiatrists and shift dependence away from a fragmented medical system.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Loneliness in early psychosis: a qualitative study exploring the views of mental health practitioners in early intervention services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Theodora Stefanidou ◽  
Jingyi Wang ◽  
Nicola Morant ◽  
Brynmor Lloyd-Evans ◽  
Sonia Johnson
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Public Health Problem ◽  
Early Psychosis ◽  
Mental Health Practitioners ◽  
First Episode ◽  
Physical And Mental Health ◽  
Early Intervention Services ◽  
Health Practitioners ◽  
Intervention Services

Abstract Background Loneliness is an important public health problem with established adverse effects on physical and mental health. Although people with psychosis often experience high levels of loneliness, relatively little is known about the relationship between loneliness and early psychosis. Potential interventions to address loneliness might be easier to implement early in the illness when social networks and social skills may be more intact than at a later stage. We investigated the views of mental health practitioners about the context and causes of loneliness in people with early psychosis, and about potential interventions. Methods Semi-structured face-to-face interviews were conducted with mental health practitioners (n = 20). Participants were purposively recruited from four early intervention services for first-episode psychosis in the UK. Interviews were transcribed verbatim and thematic analysis was conducted. Results Participants believed that the majority of service users with early psychosis experience feelings of loneliness. They often saw socially isolated and disconnected clients and believed them to be lonely, but rarely discussed loneliness explicitly in clinical interactions. A combination of symptoms, stigma and negative sense of self were believed to underpin loneliness. Participants could not identify any specific current interventions delivered by their services for tackling loneliness, but thought some routinely provided interventions, including social groups and psychological treatments, could be helpful. They favoured making a wider range of loneliness interventions available and believed that community agencies beyond mental health services should be involved to make these effective and feasible to deliver. They suggested social participation interventions without an explicit mental health focus as potentially promising and valued a co-produced approach to intervention development. Conclusions This study suggests that loneliness is not routinely discussed in early intervention services, and a targeted strategy for tackling it is lacking. Co-produced, individualised community approaches, and interventions that target symptoms, stigma and negative self-schemas might be beneficial in alleviating loneliness for people with early psychosis. Empirical research is needed to develop and test such interventions.

Gender differences in patients with first-episode psychosis in the Singapore Early Psychosis Intervention Programme

2015 ◽  
Vol 10 (6) ◽  
pp. 528-534 ◽  
Author(s):  
Shirlene Pang ◽  
Mythily Subramaniam ◽  
Edimansyah Abdin ◽  
Lye Yin Poon ◽  
Siow Ann Chong ◽  
...  
Keyword(s):  
Gender Differences ◽  
First Episode Psychosis ◽  
Early Psychosis ◽  
First Episode ◽  
Intervention Programme ◽  
Episode Psychosis

scholarly journals Three-Year Outcome of Treatment in an Early Psychosis Program

2009 ◽  
Vol 54 (9) ◽  
pp. 626-630 ◽  
Author(s):  
Jean Addington ◽  
Donald Addington
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Negative Symptoms ◽  
Family Physicians ◽  
Early Psychosis ◽  
First Episode ◽  
Significant Group ◽  
Specialized Mental Health

Objective: Studies defining the course and outcome of people experiencing their first episode psychosis (FEP) generally report an improvement in symptoms and functioning. Little is known about the follow-up arrangements offered topatients when their timein a FEP comes to an end. Method: Our study focuses on a sample of FEP patients ( n = 292) who were followed for up to 3 years in a multi-element specialized FEP service. Results: Improvement in positive symptoms and social functioning, but not negative symptoms, was observed in this sample both for people who completed 3 years in the program and for those who left early. About 40% were referred to specialized mental health services, whereas 24% were followed by their family physician. Patients who were followed by family physicians had decreased symptoms and improved functioning. Conclusion: Most patients treated in an early psychosis program will need follow-up, the largest group will require specialized mental health services in the community, but a significant group can be followed by family physicians.

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