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Early Interv Psychiatry. 2018 Aug;12(4):757-764. doi: 10.1111/eip.12514. Epub 2017 Nov 16.

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

Author information

1
Mental Health Centre North Zealand, University of Copenhagen, Hilleroed, Denmark.
2
Mental Health Centre Copenhagen, University of Copenhagen, Denmark.
3
Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan.
4
Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London, UK.
5
Hospital General Universitario Gregorio Marañón, Universidad Complutense, School of Medicine, CIBERSAM, IiSGM, Madrid, Spain.
6
Institute of Health and Society, University of Worcester, Worcester, UK.
7
Lecco Mental Health Department, Lecco, Italy.
8
Department of Early Psychosis Intervention, Institute of Mental Health, Singapore, Singapore.
9
Department of Prevention, Health Ministry, Rome, Italy.
10
Department of Psychiatry, University of Cambridge, Cambridge, UK.

Abstract

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.

KEYWORDS:

early intervention in psychosis (EIP); evidence-based medicine; health planning; implementation; mental health services

PMID:
29143456
DOI:
10.1111/eip.12514

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