By Dr Beenish Memon, Psychiatrist
Psychosis is a condition which affects people's mind in such a way that it alters the way they think, feel and behave. They find it hard to separate reality from non-reality. Core clinical symptoms include hallucinations (perceive to hear, see, taste, feel things which are not real), delusions (false fixed beliefs), Thought disorder (patient feels his thoughts are not his own or other people can read their thoughts).They can also present with emotional apathy, lack of drive, poverty of speech, social withdrawal and self-neglect. When someone experiences any or group of these symptoms for the first time than they are diagnosed as having “First Episode Psychosis ( FEP)”.
What are EIP Services?
Early Intervention in Psychosis services works with people who are at risk of developing psychosis or have been diagnosed as having First Episode Psychosis (FEP). It is crucial that people with FEP are identified, provided with support and treatment early on in their diagnosis as it significantly improves the outcome and prognosis. The delay in treatment or people with long duration of untreated psychosis are difficult to treat and they more likely to experience poor physical health, poor social and occupational functioning and poor educational outcomes.
What led to the establishment of EIP?
Around 1980’s extensive research was done on First episode psychosis and it was identified that delay in treatment in First episode psychosis was leading to high risk of morbidity/disability (Johnstone et al., 1986; Rabiner et al.,1986). It was felt that there was a lack of services available to identify and treat the First episode in Psychosis. In the 1990s there was more evidence to support this (Wiersma et al., 1998) hence early psychosis clinical services were established, first in Melbourne and later on in many important locations in the UK, Europe and North America
Recent changes to EIP and Why?
Recent evidence suggests that Early Intervention in Psychosis reduces the severity of symptoms, risks, relapse rates, and inpatient admissions (Garety et al., 2006; Craig et al., 2004).It is also identified as being cost-effective (McCrone et al., 2011). There is a significant impact on patient’s health, personal and social needs when treatment and support are not provided earlier in the illness.
It is essential to provide better access and care with a full range of interventions recommended by NICE to enable recovery in patients who are at risk of developing psychosis and First episode psychosis. EIP services now treat patients between the age of 14-65 instead of 14-35.
The government in England introduced following New standards in April 2016 for EIP services. These standards are derived from the NICE quality standard for the care of people with psychosis and schizophrenia in adults 2015 (QS80)
EIP have got an open referral policy, and patients can be referred by anyone including Primary care services, family, educational services, and other mental health services.
Finally, new Early Intervention in Psychosis standards and targets introduced in April 2016 are par with The National Cancer targets since they both aim to promote earlier diagnosis, increased access to treatment thus improving survival rates and reducing morbidity and mortality through a variety of means.
1. Johnstone, E.C., Crow, T.J., Johnson, A.L. and MacMillan, J.F. (1986) ‘The Northwick Park study of first episodes of schizophrenia. I. Presentation of the illness and problems relating to admission’, The British Journal of Psychiatry, 148(2), pp. 115–120. doi: 10.1192/bjp.148.2.115.
2. Rabiner CJ, Wegner JT, Kane JM. Outcome study of first-episode psychosis. I: Relapse rates after 1 year (1986) American Journal of Psychiatry, 143(9), pp. 1155–1158. doi: 10.1176/ajp.143.9.1155.
3. Wiersma, D., Nienhuis, F.J., Slooff, C.J. and Giel, R. (1998) ‘Natural course of schizophrenic disorders: A 15-Year followup of a Dutch incidence cohort’, Schizophrenia Bulletin, 24(1), pp. 75–85. doi: 10.1093/oxfordjournals.schbul.a033315.
4. Garety PA, Craig TK, Dunn G, Fornells-Ambrojo M, Colbert S, Rahaman N, et al. (2006) ‘Specialised care for early psychosis: Symptoms, social functioning and patient satisfaction: Randomised controlled trial’, The British Journal of Psychiatry, 188(1), pp. 37–45. doi: 10.1192/bjp.bp.104.007286.
5. McCrone, P., Park, A. and Knapp, M. (2011) ‘Cost-effectiveness of early intervention services for psychosis’, Psychiatrische Praxis, 38(S 01). doi: 10.1055/s-0031-1277798.
6. Craig TK, Garety P, Power P, Rahaman N, Colbert S, Fornells-Ambrojo M, et al. (2004) ‘The Lambeth early onset (LEO) team: Randomised controlled trial of the effectiveness of specialised care for early psychosis’, BMJ, 329(7474), pp. 1067–0. doi: 10.1136/bmj.38246.594873.7c.
Cite this article as:
Beenish Memon (2017). What are Early Intervention in Psychosis( EIP) services? .The Beautiful Space-A journal of Mind, Art and Poetry. March 2017: TBSB113
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