A controlled evaluation of a targeted early case detection intervention for reducing delay in treatment of first episode psychosis

Malla, Ashok; Jordan, Gerald; Joober, Ridha; Schmitz, N.; Norman, Ross; Brown, Thomas G.; Goldberg, Karen A.; Loohuis, Heleen; Vracotas, Nadia; Rochford, Joseph

doi:10.1007/s00127-014-0893-1

Cited by 23 publications

(36 citation statements)

References 26 publications

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“…In addition, campaigns directed at the community or even primary care for improving mental health literacy for individual disorders, usually with the objective of reducing delay in help seeking and treatment, have generally exposed the inadequacies of such diagnosis specific strategies [11,12]. It appears that such literacy and knowledge transfer may be better applied for recognition and early intervention of a broader spectrum of mental health problems.…”

Section: Early Intervention In Psychosis and Youth Mental Health Servmentioning

confidence: 99%

From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people

Malla

Iyer

McGorry

et al. 2015

Soc Psychiatry Psychiatr Epidemiol

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Abstract:Purpose: Developments in the field of early intervention in psychotic disorders have encouraged further examination of and interest in youth mental health incorporating all levels of severity of mental disorders. Methods:The authors have briefly reviewed the relevant current state of knowledge, challenges and the service and research response across four countries (Australia, Ireland, the U.K. and Canada) most active in this field.Results: Here we present information on response to principal challenges associated with improving youth mental services in each country. Australia has developed a model comprised of a distinct front line youth mental health service (Headspace) to be implemented across the country and initially stimulated by success in early intervention in psychosis;in Ireland, Headstrong has been driven primarily through advocacy and philanthropy resulting in front line services (Jigsaw) which are being implemented across different jurisdictions; in the UK a limited regional response has addressed mostly problems with transition from child-adolescent to adult mental health services; and in Canada a national multi-site research initiative involving transformation of youth mental health services has been launched with public and philanthropic funding, with the expectation that results of this study will inform implementation of a transformed model of service across the country including indigenous peoples. Conclusions:There is evidence that several countries are now engaged in transformation of youth mental health services and in evaluation of these initiatives.

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Section: Early Intervention In Psychosis and Youth Mental Health Servmentioning

confidence: 99%

From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people

Malla

Iyer

McGorry

et al. 2015

Soc Psychiatry Psychiatr Epidemiol

Self Cite

157

163

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“…We have previously reported that this TCI led to an increase in the number of eligible FEP cases referred (Malla et al, 2014). We have previously reported that this TCI led to an increase in the number of eligible FEP cases referred (Malla et al, 2014).…”

Section: Introductionmentioning

confidence: 87%

“…TCIs for early psychosis have typically focused on either the FEP or CHR stage (Addington, McGregor, Marulanda, & Raedler, 2013;Dixon, Goldman, Srihari, & Kane, 2018;Joa et al, 2007;Lloyd-Evans et al, 2011;Malla et al, 2014;Mitter, Nah, Bong, Lee, & Chong, 2014;Perez et al, 2015;Power et al, 2007;Srihari et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Does an integrated outreach intervention targeting multiple stages of early psychosis improve the identification of individuals at clinical high risk?

McIlwaine

Jordan

Pruessner

et al. 2018

Early Intervention Psych

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Aims: To explore the impact of a targeted case identification intervention, with training and education regarding first-episode psychosis and clinical high-risk syndromes, on the referral and identification of those at high risk.Methods: Using a historical control design, referral information from pre-intervention and postintervention periods was collected via administrative data and clinician notes from a catchmentbased early psychosis service.Results: A significant increase in the number of referrals sent to the service's clinical high-risk unit was observed following the intervention (P = 0.01). The proportion of referrals eligible was significantly higher post-intervention (P = 0.03), with the majority (26/44, 59.1%) referred via the first-episode psychosis service unit.Conclusions: An integrated outreach intervention for both first-episode psychosis and the clinical high-risk state was effective in increasing referrals of eligible cases to the service's at-risk unit. Rather than being stage-specific, targeted case identification strategies and service integration should span across the early stages of psychosis. K E Y W O R D Sclinical high risk for psychosis, early case identification, first-episode psychosis, specialized early intervention services, targeted case identification

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“…As studies have shown, the first point of contact for individuals with onset of psychosis is often a family physician or hospital emergency provider,30 efforts have been made to provide education to healthcare providers to facilitate appropriate referrals to specialized services. Although some research has shown that targeted educational campaigns have potential to reduce delays in the receipt of care,17 other studies have found that similar educational interventions do not result in a significant reduction in delay of referral to specialized care – even when an external specialized first-episode care program is readily available 70. Of note, one study found that if the first treatment contact point for an individual with FEP is in the community mental health setting, the delay in the receipt of specialized intervention services was even longer than for those who presented initially to emergency or crisis services 21.…”

Section: Multilevel Factors Influencing Access To Specialized Carementioning

confidence: 99%

Improving access to specialized care for first-episode psychosis: an ecological model

Moe¹,

Rubinstein²,

Gallagher³

et al. 2018

RMHP

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Psychotic spectrum disorders are serious illnesses with symptoms that significantly impact functioning and quality of life. An accumulating body of literature has demonstrated that specialized treatments that are offered early after symptom onset are disproportionately more effective in managing symptoms and improving outcomes than when these same treatments are provided later in the course of illness. Specialized, multicomponent treatment packages are of particular importance, which are comprised of services offered as soon as possible after the onset of psychosis with the goal of addressing multiple care needs within a single care setting. As specialized programs continue to develop worldwide, it is crucial to consider how to increase access to such specialized services. In the current review, we utilize an ecological model of understanding barriers to care, with emphasis on understanding how individuals with first-episode psychosis interact with and are influenced by a variety of systemic factors that impact help-seeking behaviors and engagement with treatment. Future work in this area will be important in understanding how to most effectively design and implement specialized care for individuals early in the course of a psychotic disorder.

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A controlled evaluation of a targeted early case detection intervention for reducing delay in treatment of first episode psychosis

Abstract: The intervention failed to reduce R-DUP for patients making contact with or referred from community services and most patients still used hospital resources to enter treatment at the EI service.

Cited by 23 publications

References 26 publications

From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people

From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people

Does an integrated outreach intervention targeting multiple stages of early psychosis improve the identification of individuals at clinical high risk?

Improving access to specialized care for first-episode psychosis: an ecological model

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