Early intervention in psychosis

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Description: Experimental pathway for early intervention in patients with suspected psychosis

Publet Introduction:

There is good evidence that early intervention in psychosis (EIP) services, when delivered in accordance with NICE standards, help people to recover from a first episode of psychosis and gain a good quality of life:

  • 35% of people under their care are in employment, compared with 12% in traditional care; 
  • The likelihood of an individual receiving compulsory treatment during the first two months of psychosis is 44% compared with 23% with usual care;
  • A young person’s suicide risk is reduced from up to 15% to 1%. 

Currently far too few individuals experiencing or at high risk of first episode psychosis are receiving the ‘right care’ at the ‘right time’ in the UK and there can be very long delays in accessing some of the key effective interventions recommended by NICE, the UK standard body, particularly the recommended psychological therapies like CBT for psychosis and family therapy. but also physical healthcare interventions and employment support (e.g. individual placement and support schemes). 

The UK National Health Service has published a new standard "Guidance to support the introduction of access and waiting time standards for mental health services in 2015/16to ensure that: 

1. Anyone with an emerging psychosis and their families and key supporters can have timely access to specialist early intervention services which provide interventions suited to age and phase of illness. 

2. Individuals experiencing first episode psychosis have consistent access to a range of evidence-based biological, psychological and social interventions as recommended by the NICE guidelines for psychosis and schizophrenia in children and young people CG155 (2013) and in adults CG178 (2014) and the NICE guideline for psychosis with co-existing substance misuse. 

3. Care is provided equitably - taking into account higher rates of psychosis in certain groups who may experience difficulties in accessing traditional services. 

Guideline objectives

The new NHS standard is published as a document, the traditional and familiar format for disseminating policies and clinical guidance, but a format that is known to have limited impact on practice.  This publet explores the idea that new standards of care can be delivered in the form of executable care pathways, at the point of care. The complete application will provide a range of point of care services including decision support for triaging patients presenting with a possible first psychotic episode, workflow management for detailed assessment of patients suspected of experiencing a psychotic episode, and support for selecting the appropriate care plan and assisting long-term followup of patients. The publet incorporates a structured, standardised data model for recording data in electronic patient records and facilitating quality audit and research. Future versions of the application are intended to provide additional support for multidisciplinary clinical teams, and a range of services for patient themselves, their families and carers.

Target setting Emergency services
Target users General clinicians and specialist mental health professionals


Provenance 1. A successful randomised trial of the application has been carried out
  • Author: Sarah Amani, John Fox
  • Release date:
  • Status: Draft - Under Development
  • History: Edited on 30/4/2015
Safety case Not assessed