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Research and practice for ultra-high risk for psychosis: A national survey of early intervention in psychosis services in England

Published online by Cambridge University Press:  23 March 2020

H. Stain ,
L. Mawn ,
S. Common ,
M. Pilton  and
T. Andrew
H. Stain
Affiliation:
Leeds Trinity University, School of Social and Health Sciences, Horsforth Leeds, United Kingdom
L. Mawn
Affiliation:
Newcastle University, School of Psychology, Newcastle upon Tyne, United Kingdom
S. Common
Affiliation:
Tees Esk and Wear Valleys NHS Foundation Trust, Early Intervention in Psychosis, Durham, United Kingdom
M. Pilton
Affiliation:
Newcastle upon Tyne Hospitals NHS Foundation Trust, Early Intervention, Newcastle upon Tyne, United Kingdom
T. Andrew
Affiliation:
University of Warwick, Division of Mental Health and Wellbeing, Warwick Medical School, Warwick, United Kingdom

Abstract

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Objectives

Evidence from meta-analyses of randomised clinical trials shows interventions for young people at ultra-high risk (UHR) of developing psychosis are effective both clinically and economically. While research evidence has begun to be integrated into clinical guidelines, there is a lack of research on the implementation of these guidelines. This paper examines service provision for UHR individuals in accordance with current clinical guidelines within the National Health Service (NHS) in England.

Method

A self-report online survey was completed by clinical leaders of Early Intervention in Psychosis (EIP) teams (n = 50) within the NHS across the UK.

Results

Of the 50 EIP teams responding (from 30 NHS Trusts), 53% reported inclusion of the UHR group in their service mandate, with age range predominantly 14–5 years (81%) and service provided for at least 12 months (53%). Provision of services according to NICE clinical guidelines showed 50% of services offered cognitive behavioural therapy (CBT) for psychosis, and 42% offered family intervention. Contrary to guidelines, 50% of services offered antipsychotic medication. Around half of services provided training in assessment by CAARMS, psycho-education, CBT for psychosis, family work and treatment for anxiety and depression.

Conclusions

Despite clear evidence for the benefit of early intervention in this population, current provision for UHR within EIP services in England does not match clinical guidelines. While some argue this is due to a lack of allocated funding, it is important to note the similar variable adherence to clinical guidelines in the treatment of people with established schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster walk: Schizophrenia and other psychotic disorders–part 1
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S191 - S192
Copyright
Copyright © European Psychiatric Association 2017
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