Early intervention in psychosis: From clinical intervention to health system implementation

TY - JOUR

T1 - Early intervention in psychosis

T2 - From clinical intervention to health system implementation

AU - Csillag, Claudio

AU - Nordentoft, Merete

AU - Mizuno, Masafumi

AU - McDaid, David

AU - Arango, Celso

AU - Smith, Jo

AU - Lora, Antonio

AU - Verma, Swapna

AU - Di Fiandra, Teresa

AU - Jones, Peter B

N1 - © 2017 John Wiley & Sons Australia, Ltd.

PY - 2018/8

Y1 - 2018/8

N2 - AIM: Early intervention in psychosis (EIP) is a well-established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges to their implementation and presents ideas and strategies to overcome some of these obstacles.METHODS: This paper is a narrative review about the evidence supporting EIP, with examples of successful implementation of EIP and of cases where major obstacles still need to be overcome.RESULTS: Experience from successfully implemented EIP services into the mental healthcare system have generated evidence, concepts and specific strategies that might serve as guidance or inspiration in other countries or systems where EIP is less well developed or not developed at all. Previous experience has made clear that evidence of clinical benefits alone is not enough to promote implementation, as economic arguments and political and social pressure have shown to be important elements in efforts to achieve implementation.CONCLUSIONS: Users' narratives, close collaboration with community organizations and support from policy-makers and known people within the community championing early intervention (EI) services are just a few of the approaches that should be considered in campaigns for implementation of EI services. Fast progress in implementation is possible.

AB - AIM: Early intervention in psychosis (EIP) is a well-established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges to their implementation and presents ideas and strategies to overcome some of these obstacles.METHODS: This paper is a narrative review about the evidence supporting EIP, with examples of successful implementation of EIP and of cases where major obstacles still need to be overcome.RESULTS: Experience from successfully implemented EIP services into the mental healthcare system have generated evidence, concepts and specific strategies that might serve as guidance or inspiration in other countries or systems where EIP is less well developed or not developed at all. Previous experience has made clear that evidence of clinical benefits alone is not enough to promote implementation, as economic arguments and political and social pressure have shown to be important elements in efforts to achieve implementation.CONCLUSIONS: Users' narratives, close collaboration with community organizations and support from policy-makers and known people within the community championing early intervention (EI) services are just a few of the approaches that should be considered in campaigns for implementation of EI services. Fast progress in implementation is possible.

U2 - 10.1111/eip.12514

DO - 10.1111/eip.12514

M3 - Journal article

C2 - 29143456

SN - 1751-7885

VL - 12

SP - 757

EP - 764

JO - Early Intervention in Psychiatry

JF - Early Intervention in Psychiatry

IS - 4

ER -