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Research and practice for ultra-high risk for psychosis : a national survey of early intervention in psychosis services in England
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Stain, Helen J., Mawn, Lauren, Common, Stephanie, Pilton, Marie and Thompson, Andrew David (2019) Research and practice for ultra-high risk for psychosis : a national survey of early intervention in psychosis services in England. Early Intervention in Psychiatry, 13 (1). pp. 47-52. doi:10.1111/eip.12443 ISSN 1751-7885.
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Official URL: http://dx.doi.org/10.1111/eip.12443
Abstract
Background:
Evidence from meta-analyses of randomized clinical trials show 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 (Nā=ā50) within the NHS across England.
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 to 35 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 Comprehensive Assessment of At Risk Mental States, 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.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Psychoses in children -- Treatment -- Standards -- England | ||||||||
| Journal or Publication Title: | Early Intervention in Psychiatry | ||||||||
| Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||||
| ISSN: | 1751-7885 | ||||||||
| Official Date: | February 2019 | ||||||||
| Dates: |
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| Volume: | 13 | ||||||||
| Number: | 1 | ||||||||
| Page Range: | pp. 47-52 | ||||||||
| DOI: | 10.1111/eip.12443 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Date of first compliant deposit: | 3 July 2017 | ||||||||
| Date of first compliant Open Access: | 14 June 2018 |
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