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Early Interv Psychiatry. 2018 Dec;12(6):1222-1228. doi: 10.1111/eip.12564. Epub 2018 Mar 26.

Description, evaluation and scale-up potential of a model for rapid access to early intervention for psychosis.

MacDonald K1,2,3, Malla A1,2,3, Joober R1,2,3, Shah JL1,2,3, Goldberg K4, Abadi S4, Doyle M5, Iyer SN1,2,3.

Author information

1
Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
2
Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Quebec, Canada.
3
ACCESS Open Minds (Pan-Canadian youth mental health services research network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.
4
Douglas Mental Health University Institute, Montreal, Quebec, Canada.
5
Concordia University, Montreal, Quebec, Canada.

Abstract

AIM:

This paper aims to describe the entry protocol of the Prevention and Early Intervention for Psychosis Program (PEPP)-Montreal, an early intervention program for psychosis. The protocol is designed to fulfil a key objective of the early intervention movement-reducing delays to accessing high-quality care. The paper also aims to describe how this rapid entry protocol can be deployed in other services interested in reducing delays in initiating treatment.

METHODS:

PEPP provides rapid, easy access to quality care by placing a single, well-trained professional, the intake clinician, at the point of entry. Anyone can refer a youth directly and without formalities to the intake clinician who responds promptly and sensitively to all help-seeking, whether by a youth, a family member, a school counsellor or anyone acting on behalf of a youth in need. To promote accessibility, PEPP guarantees an initial assessment within 72 hours; maintains relationships with referral sources; and conducts awareness-enhancing outreach activities.

RESULTS:

Since 2003, PEPP has received 1750 referrals, which have all been responded to within 72 hours. Families have been involved in the intake process in 60% of the cases and hospitalization may have been averted in over half of the referrals originating from emergency-room services. Another indicator of success is the very low turnover in the intake clinician's position. Overall, the PEPP model has succeeded in providing rapid, engaging, easy and youth-friendly access to high-quality care.

CONCLUSION:

The success of this protocol at PEPP has inspired the entry protocols at other first-episode psychosis services. Its ability to provide rapid, engaging access to high-quality services may allow this protocol to become a model for other early intervention services for psychosis and other mental illnesses.

KEYWORDS:

early intervention; first-episode psychosis; health services accessibility; intake; treatment delays

PMID:
29582562
DOI:
10.1111/eip.12564

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