Implementing the access and waiting time standard for early intervention in psychosis in the United Kingdom: An evaluation of referrals and post‐assessment outcomes over the first year of operation

Adamson, Vidyah; Barrass, Emma; McConville, Stephen; Irikok, Chantelle; Taylor, Karen; Pitt, Steve; Duyn, Rob Van; Bennett, Susan; Jackson, Lisa R.; Carroll, Jon; Andrews, Mark; Parker, Ann M.; Wright, Caroline; Greathead, Katie; Price, David

doi:10.1111/eip.12548

Cited by 18 publications

(25 citation statements)

References 30 publications

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“…Resource-light interventions for carers are beneficial not only to mental health services, but for carers themselves. FEP services are stretched (Adamson et al, 2018) so a briefer intervention for carers may be more feasible for mental health practitioners to deliver. Similarly, a fundamental challenge associated with being a carer is finding time for yourself (Cleary et al, 2006) so, again, an intervention that requires less of a time commitment may be easier for carers to attend.…”

Section: Discussionmentioning

confidence: 99%

Service evaluation of a sole-session psychoeducational intervention to improve caregivers’ key illness beliefs after first episode psychosis (FEP)

Hazell

Lyons

Onwumere

et al. 2020

tCBT

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Carers of people experiencing a first episode of psychosis are at an increased risk of developing their own physical and mental health problems. Psychoeducation has been found to improve carer wellbeing and reduce distress. However, few psychoeducation interventions have considered the resource constraints on mental health services and the impact that these can have on the implementation of any such interventions. The present service evaluation aimed to evaluate an abbreviated version (sole session) of a previously tested psychoeducation intervention (three sessions) that targets less adaptive illness beliefs (n = 17). Pre–post effect sizes reveal that all of the carers’ illness beliefs changed in the desired direction, with four out of the 10 illness beliefs associated with large to moderate improvements. When compared with the outcomes obtained in our evaluation of the more intensive, three-session version of the intervention, the between-group effects largely favoured the three-session version but were mostly small. Moderate to large effects in favour of the three-session version were found for two of the 10 illness beliefs. These findings support the further investigation of the sole session psychoeducation intervention as part of a randomised controlled trial. Key learning aims (1) To evaluate the impact of a sole-session psychoeducation intervention on illness beliefs. (2) To compare the outcomes of the sole-session psychoeducation intervention to the previous, more intensive (three-session) version of the same intervention. (3) To consider the value of research approaches to evaluating psychoeducation interventions for carers of people with psychosis.

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Section: Discussionmentioning

confidence: 99%

Service evaluation of a sole-session psychoeducational intervention to improve caregivers’ key illness beliefs after first episode psychosis (FEP)

Hazell

Lyons

Onwumere

et al. 2020

tCBT

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“…Currently the new EIP services are limited to those aged 14-64 and do not yet include specialist services such as Intellectual Disability or Forensic Psychiatry as there is no evidence base as yet to show which EIP service model best suits these specialties. Indeed, most of the evidence base for EIP service models comes from youth-oriented EIP services (McDaid et al 2016) and uncertainty remains about which model best meets the needs of 35-64 year olds (Greenfield et al 2018;Adamson et al 2018). The MoC focuses on community EIP services and does not include setting up specialised EIP inpatient beds (there are only a handful of such specialist units overseas).…”

Section: The Model Of Care For Eip Servicesmentioning

confidence: 99%

“…When they are fully operational in Ireland, EIP services will be serving approximately 1500 new cases of psychosis (aged 14-65) a year. Two thirds will be under the age of 35, and 15% will be under the age of 18 (Singh et al 2003;Baldwin et al 2005;Greenfield et al 2018;Adamson et al 2018). With 3 years follow-up, that will mean a total active case load in EIP services of over 4000 (with about 500 in CAMHS).…”

Section: The Introduction Of Eip Services In Irelandmentioning

confidence: 99%

Early intervention services for psychosis in Ireland: are we there yet?

Power

2019

Ir. j. psychol. Med.

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Early intervention in psychosis (EIP) services are now a priority for Ireland’s Health Service Executive (HSE). A Model of Care for EIP services has been completed after wide consultation. It has just been launched by the Minister for Mental Health and the aim now is to roll out EIP services throughout the country. The Model of Care outlines the rational, configuration, resources, governance, and quality assurance required to operate EIP services. Two models are recommended. The first is a Hub & Spoke service model for rural and smaller urban areas. The second is a Stand-Alone service model for large urban and metropolitan areas. Introducing EIP services is going to be a challenge but there are plenty of good examples overseas. They have been shown to greatly enhance local services’ ability to meet the needs of people developing psychotic disorders. They bring with them better outcomes, service satisfaction and cost savings.

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“…This finding has clear-cut clinical implications. For example, NHS England, in April 2016 has implemented a new Access and Waiting Times-Standard for Early Intervention in psychosis, which requires that CHR-P are detected nationwide and treated rapidly (25, 26). Although it is now an NHS requirement that all suspected CHR-P patients who present to NHS Trusts are assessed and interviewed for a psychosis-risk state (13), such an approach is likely to miss the vast majority of those at risk.…”

Section: Introductionmentioning

confidence: 99%

Real World Implementation of a Transdiagnostic Risk Calculator for the Automatic Detection of Individuals at Risk of Psychosis in Clinical Routine: Study Protocol

et al. 2019

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Background: Primary indicated prevention in individuals at-risk for psychosis has the potential to improve the outcomes of this disorder. The ability to detect the majority of at-risk individuals is the main barrier toward extending benefits for the lives of many adolescents and young adults. Current detection strategies are highly inefficient. Only 5% (standalone specialized early detection services) to 12% (youth mental health services) of individuals who will develop a first psychotic disorder can be detected at the time of their at-risk stage. To overcome these challenges a pragmatic, clinically-based, individualized, transdiagnostic risk calculator has been developed to detect individuals at-risk of psychosis in secondary mental health care at scale. This calculator has been externally validated and has demonstrated good prognostic performance. However, it is not known whether it can be used in the real world clinical routine. For example, clinicians may not be willing to adhere to the recommendations made by the transdiagnostic risk calculator. Implementation studies are needed to address pragmatic challenges relating to the real world use of the transdiagnostic risk calculator. The aim of the current study is to provide in-vitro and in-vivo feasibility data to support the implementation of the transdiagnostic risk calculator in clinical routine.Method: This is a study which comprises of two subsequent phases: an in-vitro phase of 1 month and an in-vivo phase of 11 months. The in-vitro phase aims at developing and integrating the transdiagnostic risk calculator in the local electronic health register (primary outcome). The in-vivo phase aims at addressing the clinicians' adherence to the recommendations made by the transdiagnostic risk calculator (primary outcome) and other secondary feasibility parameters that are necessary to estimate the resources needed for its implementation.Discussion: This is the first implementation study for risk prediction models in individuals at-risk for psychosis. Ultimately, successful implementation is the true measure of a prediction model's utility. Therefore, the overall translational deliverable of the current study would be to extend the benefits of primary indicated prevention and improve outcomes of first episode psychosis. This may produce significant social benefits for many adolescents and young adults and their families.

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Implementing the access and waiting time standard for early intervention in psychosis in the United Kingdom: An evaluation of referrals and post‐assessment outcomes over the first year of operation

Cited by 18 publications

References 30 publications

Service evaluation of a sole-session psychoeducational intervention to improve caregivers’ key illness beliefs after first episode psychosis (FEP)

Service evaluation of a sole-session psychoeducational intervention to improve caregivers’ key illness beliefs after first episode psychosis (FEP)

Early intervention services for psychosis in Ireland: are we there yet?

Real World Implementation of a Transdiagnostic Risk Calculator for the Automatic Detection of Individuals at Risk of Psychosis in Clinical Routine: Study Protocol

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