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Reducing duration of untreated psychosis: care pathways to early intervention in psychosis services
Max Birchwood et al., British Journal of Psychiatry, July 2013, Volume 203 Issue 1
Abstract
Background
Interventions to reduce treatment delay in first-episode psychosis have met with mixed results. Systematic reviews highlight the need for greater understanding of delays within the care pathway if successful strategies are to be developed.
Aims
To document the care-pathway components of duration of untreated psychosis (DUP) and their link with delays in accessing specialised early intervention services (EIS). To model the likely impact on efforts to reduce DUP of targeted changes in the care pathway.
Method
Data for 343 individuals from the Birmingham, UK, lead site of the National EDEN cohort study were analysed.
Results
A third of the cohort had a DUP exceeding 6 months. The greatest contribution to DUP for the whole cohort came from delays within mental health services, followed by help-seeking delays. It was found that delay in reaching EIS was strongly correlated with longer DUP.
Conclusions
Community education and awareness campaigns to reduce DUP may be constrained by later delays within mental health services, especially access to EIS. Our methodology, based on analysis of care pathways, will have international application when devising strategies to reduce DUP.
Correspondence: Max Birchwood, PhD, DSc, CPsychol, FBPsS, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Email: m.j.birchwood.20@bham.ac.uk
Max Birchwood et al., British Journal of Psychiatry, July 2013, Volume 203 Issue 1
Abstract
Background
Interventions to reduce treatment delay in first-episode psychosis have met with mixed results. Systematic reviews highlight the need for greater understanding of delays within the care pathway if successful strategies are to be developed.
Aims
To document the care-pathway components of duration of untreated psychosis (DUP) and their link with delays in accessing specialised early intervention services (EIS). To model the likely impact on efforts to reduce DUP of targeted changes in the care pathway.
Method
Data for 343 individuals from the Birmingham, UK, lead site of the National EDEN cohort study were analysed.
Results
A third of the cohort had a DUP exceeding 6 months. The greatest contribution to DUP for the whole cohort came from delays within mental health services, followed by help-seeking delays. It was found that delay in reaching EIS was strongly correlated with longer DUP.
Conclusions
Community education and awareness campaigns to reduce DUP may be constrained by later delays within mental health services, especially access to EIS. Our methodology, based on analysis of care pathways, will have international application when devising strategies to reduce DUP.
Correspondence: Max Birchwood, PhD, DSc, CPsychol, FBPsS, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Email: m.j.birchwood.20@bham.ac.uk
