The pitfalls and caveats in the implementation of an early intervention service for psychotic patients in a rural region.

Abstract

In his article Introduction to ‘Early psychosis: a bridge to the future’ McGorry stated optimistically: “Early intervention in psychiatry has taken a long time to emerge as a key strategy to reduce morbidity and mortality with psychotic symptoms” It suggests that we have almost solved the problem.

The good news is that there are indeed many excellent guidelines for those young patients suffering from a psychosis. There are also translations of those guidelines into programs, for instance The Early Intervention Service (EIS) in the UK. Programs like the EIS deliver well coordinated, comprehensive care with interventions such as medication, psychosocial intervention and vocational training and are of proven evidence.

The bad news is that these programs are scarce. They only exist in a few sites in Europe. In Rivierduinen, a large mental health trust in The Netherlands, we try to implement an EIS.

In the workshop I would like to share the following topics with the audience:

The importance of developing and sustaining, with professionals and management, a golden stan-dard of care. This goes beyond the composition of guidelines and has a lot to do with knowledge management throughout the different levels of the organization.

The pitfalls in the different phases of the implementation of an Early Psychosis Guideline in a rural area with several small sub regional operating teams.

At the end of the workshop the participants are equipped with tools and suggestions to manage the implementation process.