Views of Young People in Early Intervention Services for First-Episode Psychosis in England

2011 ◽  
Vol 62 (8) ◽  
pp. 882-887 ◽  
Author(s):  
Helen Lester ◽  
Max Marshall ◽  
Peter Jones ◽  
David Fowler ◽  
Tim Amos ◽  
...  
Keyword(s):  
Early Intervention ◽  
Young People ◽  
First Episode Psychosis ◽  
First Episode ◽  
Early Intervention Services ◽  
Episode Psychosis ◽  
Intervention Services

scholarly journals Layers of listening: Qualitative analysis of the impact of early intervention services for first-episode psychosis on carers' experiences

2015 ◽  
Vol 207 (2) ◽  
pp. 135-142 ◽  
Author(s):  
Anna Lavis ◽  
Helen Lester ◽  
Linda Everard ◽  
Nicholas Freemantle ◽  
Tim Amos ◽  
...  
Keyword(s):  
Early Intervention ◽  
Young People ◽  
Help Seeking ◽  
Young Person ◽  
First Episode Psychosis ◽  
First Episode ◽  
Early Intervention Services ◽  
Episode Psychosis ◽  
Intervention Services ◽  
The Impact

BackgroundEarly intervention services (EIS) comprise low-stigma, youth-friendly mental health teams for young people undergoing first-episode psychosis (FEP). Engaging with the family of the young person is central to EIS policy and practice.AimsBy analysing carers' accounts of their daily lives and affective challenges during a relative's FEP against the background of wider research into EIS, this paper explores relationships between carers' experiences and EIS.MethodSemi-structured longitudinal interviews with 80 carers of young people with FEP treated through English EIS.ResultsOur data suggest that EIS successfully aid carers to support their relatives, particularly through the provision of knowledge about psychosis and medications. However, paradoxical ramifications of these user-focused engagements also emerge; they risk leaving carers' emotions unacknowledged and compounding an existing lack of help-seeking.ConclusionsBy focusing on EIS's engagements with carers, this paper draws attention to an urgent broader question: as a continuing emphasis on care outside the clinic space places family members at the heart of the care of those with severe mental illness, we ask: who can, and should, support carers, and in what ways?

scholarly journals Developing early intervention services in the NHS: a survey to guide workforce and training needs

2003 ◽  
Vol 27 (07) ◽  
pp. 254-258 ◽  
Author(s):  
Swaran Singh ◽  
Christine Wright ◽  
Eileen Joyce ◽  
Tom Barnes ◽  
Thomas Burns
Keyword(s):  
Early Intervention ◽  
Psychosocial Interventions ◽  
Behavioural Therapy ◽  
First Episode Psychosis ◽  
First Episode ◽  
Care Programme ◽  
Early Intervention Services ◽  
Episode Psychosis ◽  
Trained Staff ◽  
Intervention Services

Aims and Method We conducted a questionnaire study to establish the incidence, specialist staff availability, treatment provision and socio-demographic profile of patients with first-episode psychosis referred to all adult and child and adolescent community mental health teams in south and west London. Results All 39 teams completed the questionnaire, identifying 295 cases of first-episode psychosis (annual incidence 21/100 000/year) referred in the year 2000. Teams manage to engage most patients with first-episode psychosis. A total of 73% of cases of first-episode psychosis were on some form of Care Programme Approach. However, many teams did not have adequately trained staff to provide psychosocial interventions. Even where such staff were available, care was focused mainly on monitoring medication and risk assessment, with only half the teams providing psycho-educational programmes and only a quarter offering individual cognitive–behavioural therapy to those with first-episode psychosis. Clinical Implications Establishing early intervention services nationwide will require significant new resources, including specialist trained staff, which could prove difficult to provide in inner-city areas. Rather than a single, uniform service model, several models of early intervention services based on locally determined need might be more realistic and appropriate, and also allow research into their relative efficacy.

scholarly journals Development and validation of a non-remission risk prediction model in first episode psychosis: an analysis of two longitudinal studies

2021 ◽  
Author(s):  
Samuel P Leighton ◽  
Rajeev Krishnadas ◽  
Rachel Upthegrove ◽  
Steven Marwaha ◽  
Ewout W Steyerberg ◽  
...  
Keyword(s):  
Early Intervention ◽  
Prediction Model ◽  
Risk Prediction ◽  
First Episode Psychosis ◽  
Risk Prediction Model ◽  
First Episode ◽  
Early Intervention Services ◽  
Episode Psychosis ◽  
Intervention Services ◽  
Development And Validation

Abstract Psychosis is a major mental illness with first onset in young adults. The prognosis is poor in around half of the people affected, and difficult to predict. The few tools available to predict prognosis have major weaknesses which limit their use in clinical practice. We aimed to develop and validate a risk prediction model of symptom non-remission in first-episode psychosis. Our development cohort consisted of 1027 patients with first-episode psychosis recruited between 2005 to 2010 from 14 early intervention services across the National Health Service in England. Our validation cohort consisted of 399 patients with first-episode psychosis recruited between 2006 to 2009 from a further 11 English early intervention services. The one-year non-remission rate was 52% and 54% in the development and validation cohorts, respectively. Multivariable logistic regression was used to develop a risk prediction model for non-remission, which was externally validated. The prediction model showed good discrimination (C-statistic of 0.73 (0.71, 0.75) and adequate calibration with intercept alpha of 0.12 (0.02, 0.22) and slope beta of 0.98 (0.85, 1.11). Our model improved the net-benefit by 15% at a risk threshold of 50% compared to the strategy of treating all, equivalent to 15 more detected non-remitted first-episode psychosis individuals per 100 without incorrectly classifying remitted cases. Once prospectively validated, our first episode psychosis prediction model could help identify patients at increased risk of non-remission at initial clinical contact.

scholarly journals Comparison of clinical outcomes following 2 years of treatment of first-episode psychosis in urban early intervention services in Canada and India

2020 ◽  
Vol 217 (3) ◽  
pp. 514-520 ◽  
Author(s):  
Ashok Malla ◽  
Srividya N. Iyer ◽  
Thara Rangaswamy ◽  
Padmavati Ramachandran ◽  
Greeshma Mohan ◽  
...  
Keyword(s):  
Early Intervention ◽  
Family Support ◽  
Clinical Outcomes ◽  
Negative Symptom ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Early Intervention Services ◽  
Episode Psychosis ◽  
Intervention Services

BackgroundPurported superior outcomes for treatment of psychosis in low- and middle-income (LMICs) compared with high-income (HICs) countries have not been examined in the context of early intervention services (EIS).AimsTo compare 2-year clinical outcomes in first-episode psychosis (FEP) treated in EIS in Chennai (LMIC) and Montreal (HIC) using a similar EIS treatment protocol and to identify factors associated with any outcome differences.MethodPatients with FEP treated in EIS in Chennai (n = 168) and Montreal (n = 165) were compared on change in level of symptoms and rate and duration of positive and negative symptom remission over a 2-year period. Repeated-measures analysis of variance, and logistic and linear regression analyses were conducted.ResultsFour patients died in Chennai compared with none in Montreal. Family support was higher for Chennai patients (F = 14.05, d.f. = 1, P < 0.001, ƞp2 = 0.061) and increased over time at both sites (F = 7.0, d.f. = 1.915, P < 0.001, ƞp2 = 0.03). Negative symptom outcomes were significantly better in Chennai for level of symptoms (time × site interaction F = 7.36, d.f. = 1.49, P = 0.002, ƞp2 = 0.03), duration of remission (mean 16.1 v. 9.78 months, t = −7.35, d.f. = 331, P < 0.001, Cohen's d = 0.80) and the proportion of patients in remission (81.5% v. 60.3%, χ2 = 16.12, d.f. = 1, P < 0.001). The site differences in outcome remained robust after adjusting for inter-site differences in other characteristics. Early remission and family support facilitated better outcome on negative symptoms. No significant differences were observed in positive symptom outcomes.ConclusionsPatients with FEP treated in EIS in LMIC contexts are likely to show better outcome on negative symptoms compared with those in HIC contexts. Early remission and family support may benefit patients across both contexts.

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