Early intervention in psychosis: a feasibility study financed by the Italian Center on Control of Maladies

Abstract

Overall, the study proved that an EIP centre can be established within the public Department of Mental Health to reach a good fraction of the cases in need of treatment. Since then, several studies have been set up to assess the feasibility of EIP in the Italian public mental health sector in Lombardy and Tuscany, and in 2012 the Emilia-Romagna Regional Authority started an educational plan aimed at implementing the EIP model in all the Mental Health Departments in the region.

The “Reggio Emilia At‐Risk Mental States” program: A diffused, “liquid” model of early intervention in psychosis implemented in an Italian Department of Mental Health

“…Approximately 300 young individuals, aged 13 to 35 years, have been consecutively referred to the ReARMS program in the 5 years following its establishment. In comparison with the referral rate observed in “Programma 2000” (Cocchi, Balbi, et al, ; Cocchi, Cavicchini, et al, ), our finding is definitely higher, suggesting that a diffused, “liquid” infrastructure specifically involving all the local CAMHS and AMHS is probably more able to effectively meet and respond to the care needs of help‐seeking users, placing in close proximity with them. Indeed, in 11 years of clinical activity (from January 1999 to December 2010), about 400 young subjects, aged 17 to 30 years, were assessed in the “Programma 2000”, the first Italian EIP centralized service ongoing in Milan within the Department of Mental Health of the “Niguarda Ca’ Granda” Hospital, a catchment area catering to approximately 200 000 inhabitants (Cocchi et al, ).…”

“…In the last 25 years, since the seminal works of McGorry and McGlashan (McGlashan, ; McGorry, ), the paradigm of early intervention in psychosis (EIP) has obtained increased attention in the scientific community, sprouting focused protocol of care that have been implemented in EIP programs and sometimes in autonomous EIP services within the mental health care network of different countries (Cocchi, Balbi, et al, ). This interest is raised by its rational foundation: early detection and intervention in psychosis (and in psychosis‐risk syndromes) has been expected to reduce inpatient care, treatment drop‐out, morbidity and its related disability, as well as to improve long‐term outcome of illness (McGorry, ).…”

“…Indeed, patient can book a visit even without a formal indication by his/her general practitioners. According to Cocchi, Balbi, et al (), this community mental health care system is particularly favourable for the implementation of the early intervention paradigm within the Italian public psychiatric services.…”

Implementation and development of early intervention in psychosis services in Italy: a national survey promoted by the Associazione Italiana Interventi Precoci nelle Psicosi

“…This may be a reason for the apparently low incidence of FEP in the areas with active EIP centres. As a matter of fact, some difference between the expected and the treated incidence of a disorder is a common finding in Italy, and it may depend upon the mixed nature of the mental health‐care network in Italy, where public and private facilities compete to provide treatment to the people in need …”

“…31 This may be a reason for the apparently low incidence of FEP in the areas with active EIP centres. As a matter of fact, some difference between the expected and the treated incidence of a disorder is a common finding in Italy, 32,33 and it may depend upon the mixed nature of the mental health-care network in Italy, where public and private facilities compete to provide treatment to the people in need. 34 It has been already stated that, aside from lack of funding, a robust 'cultural resistance of mental health services to change their traditional treatment Early intervention in psychosis in Italy approaches' (Ghio et al,23 p. 346) is delaying the implementation of the EIP model in the Italian context.…”