Early intervention in psychosis: A pilot study of methods to help existing staff adapt

Abstract

Background: Improved detection and clear referral systems are prerequisites for effective early intervention. Although specialist early intervention services are being introduced in Britain, changes are still required in the practice of existing primary and secondary care staff. Aims: This paper describes an exploratory evaluation of a partnership approach to help existing staff adapt their practice to support early intervention. Methods: Policies and procedures of the service described were compared systematically with national policy guidance. Structured interviews with 53 primary care and mental health staff were used to explore changes in their knowledge, attitudes and professional practice. Results: The service model complied with most UK national policy requirements for early intervention. There was increased awareness and knowledge of early psychosis and improved detection, assessment and intervention practice on the part of primary and secondary care staff.Conclusion: It appears possible to influence the practice of existing staff to deliver early intervention using an economical service model. Declaration of interest: This work was supported by educational grants from Janssen-Cilag/ Organon and Lilly.

Systematic review of the evidence for service models delivering early intervention in psychosis outside the stand‐alone centre

“…In a paper outlining a pilot study on helping staff to adapt to EI as a form of service delivery, Dodgson et al described a 'partnership model'. 34 They described the challenges of putting the principles of EI into practice in a mixed urban and rural setting. They identified excessive travel times for staff and clients, a relatively low incidence of psychosis, a relatively conservative professional culture that may be more resistant to change, in addition to small and stable communities that could result in additional concerns about stigma and reluctance therefore to make a diagnosis of psychosis.…”

What makes Early Intervention in Psychosis services effective? A Case Study

“…2 The development of this particular EIP Service has been published elsewhere. 14 The service was developed based on a hub and spoke model with a single, central clinical psychologist supporting the spoke workers, who were nurses embedded within community mental health teams. This model was adopted to compensate for the rural nature of Northumberland and the low projected annual incidence of first episode psychosis.…”

Early psychosis workforce development: Core competencies for mental health professionals working in the early psychosis field

“…However, significant expansion and replication of early psychosis services raise issues about how fidelity can be maintained (Bradach, ; Catts et al, ). Of particular concern is how existing and new clinical staff can be assisted to adapt clinical practice and implement early psychosis specific interventions (Paxton et al, ). Practitioner competence is essential to the successful implementation of any intervention or program (Bond, Evans, Salyers, Williams, & Kim, ; Waltz, Addis, Koerner, & Jacobson, ).…”

“…However, significant expansion and replication of early psychosis services raise issues about how fidelity can be maintained (Bradach, 2003;Catts et al, 2010). Of particular concern is how existing and new clinical staff can be assisted to adapt clinical practice and implement early psychosis specific interventions (Paxton et al, 2003).…”