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Reducing duration of untreated psychosis : care pathways to early intervention in psychosis services

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Birchwood, M. J., Connor, Charlotte, Lester, Helen, Patterson, Paul, Freemantle, Nick, Marshall, M., Fowler, David, Lewis, Shôn, Jones, Peter B., Amos, Tim, Everard, Linda and Singh, Swaran P. (2013) Reducing duration of untreated psychosis : care pathways to early intervention in psychosis services. The British Journal of Psychiatry, Volume 203 (Number 1). pp. 58-64. doi:10.1192/bjp.bp.112.125500 ISSN 0007-1250.

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Official URL: http://dx.doi.org/10.1192/bjp.bp.112.125500

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Abstract

Background

Interventions to reduce treatment delay in first-episode psychosis have met with mixed results. Systematic reviews highlight the need for greater understanding of delays within the care pathway if successful strategies are to be developed.

Aims

To document the care-pathway components of duration of untreated psychosis (DUP) and their link with delays in accessing specialised early intervention services (EIS). To model the likely impact on efforts to reduce DUP of targeted changes in the care pathway.

Method

Data for 343 individuals from the Birmingham, UK, lead site of the National EDEN cohort study were analysed.

Results

A third of the cohort had a DUP exceeding 6 months. The greatest contribution to DUP for the whole cohort came from delays within mental health services, followed by help-seeking delays. It was found that delay in reaching EIS was strongly correlated with longer DUP.

Conclusions

Community education and awareness campaigns to reduce DUP may be constrained by later delays within mental health services, especially access to EIS. Our methodology, based on analysis of care pathways, will have international application when devising strategies to reduce DUP.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Library of Congress Subject Headings (LCSH): Mental health services -- Great Britain -- Evaluation, Psychoses -- Treatment
Journal or Publication Title: The British Journal of Psychiatry
Publisher: Royal College of Psychiatrists
ISSN: 0007-1250
Official Date: 2013
Dates:
DateEvent
2013Published
Volume: Volume 203
Number: Number 1
Page Range: pp. 58-64
DOI: 10.1192/bjp.bp.112.125500
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Funder: National Institute for Health Research (Great Britain) (NIHR)

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