Evaluation of a community awareness programme to reduce delays in referrals to early intervention services and enhance early detection of psychosis

Lloyd-Evans, Brynmor and Sweeney, Angela and Hinton, Mark and Morant, Nicola and Pilling, Stephen and Leibowitz, Judy and Killaspy, Helen and Tanskanen, Sanna and Totman, Jonathan and Armstrong, Jessica and Johnson, Sonia (2015) Evaluation of a community awareness programme to reduce delays in referrals to early intervention services and enhance early detection of psychosis. BMC Psychiatry, 15 (98). ISSN 1471-244X

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Abstract

Background Reducing treatment delay and coercive pathways to care are accepted aims for Early Intervention Services (EIS) for people experiencing first episode psychosis but how to achieve this is unclear. A one-year community awareness programme was implemented in a London EIS team, targeting staff in non-health service community organisations. The programme comprised psycho-educational workshops and EIS link workers, and offering direct referral routes to EIS. Its feasibility and its impact on duration of untreated psychosis and pathways to EIS were evaluated. Methods Evaluation comprised: pre and post questionnaires with workshop participants assessing knowledge and attitudes to psychosis and mental health services; and a comparison of new service users’ “service DUP”(time from first psychotic symptom to first contact with EIS) and pathways to care in the intervention year and preceding year. Focus groups sought stakeholders’ views regarding the benefits and limitations of the programme and what else might promote help-seeking. Results 41 workshops at 36 community organisations were attended by 367 staff. 19 follow up workshops were conducted and 16 services were allocated an EIS link worker. Participants’ knowledge and attitudes to psychosis and attitudes to mental health services improved significantly following workshops. In the year of the intervention, only 6 of 110 new service users reached EIS directly via community organisations. For all new referrals accepted by EIS, in the intervention year compared to the previous year, there was no difference in mean or median service DUP. A clear impact on pathways to care could not be discerned. Stakeholders suggested that barriers to referral remained. These included: uncertainty about the signs of early psychosis, disengagement by young people when becoming unwell, and worries about stigma or coercive treatment from mental health services. More general, youth focused, mental health services were proposed. Conclusions The community awareness programme did not reduce treatment delays for people experiencing first episode psychosis. Further research is needed regarding effective means to reduce duration of untreated psychosis. Although EIS services are guided to promote access through community engagement, this may not be an effective use of their limited resources.

Item Type: Journal Article
Keywords: Psychosis, Early Intervention, Health education
Faculty: Faculty of Science & Technology
Depositing User: Dr Jonathan Totman
Date Deposited: 26 Jun 2017 11:18
Last Modified: 26 Jun 2017 11:18
URI: http://arro.anglia.ac.uk/id/eprint/701900

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