Early intervention in psychosis: action plan

Introduction

Why is Early Intervention in Psychosis (EIP) so important?

Psychosis is characterised by hallucinations, delusions and disturbed thinking. It can cause considerable distress and problems for people affected, and for their families or carers.

A diagnosis of schizophrenia, bipolar disorder, psychotic depression or other psychotic disorder may be made, but it can take months or years for a final diagnosis because this often requires evidence of how the condition develops over time.

There is significant evidence, e.g. Scottish Intercollegiate Guidelines Network (SIGN) guideline 131; Management of Schizophrenia, that early access to services, together with the delivery of defined evidence-based interventions, is fundamental in improving outcomes, and is highly cost effective. The time taken for the individual to start effective treatment directly affects later outcomes.

Estimates are of 1600 new presentations of psychosis in Scotland a year.

In recognition that this is a significant issue, and an area of focus for the Scottish Government, the Mental Health Strategy 2017-2017 includes Action 26:

“Ensure the propagation of best practice for early interventions for first episode psychosis, according to clinical guidelines”

Where We Are Now?

Understanding of current services for those experiencing a first episode of psychosis is limited. With the exception of a small number of specialist services, a lack of data means we have no clear indication of the current level of access to, nor the quality of, services.

To guide the development of this work, Healthcare Improvement Scotland (HIS) formed a Short Life Working Group (SLWG), surveyed every NHS Board, and carried out diagnostics within two Boards to provide case studies. The findings of this work can be found at the Annex A.