TY - JOUR
T1 - Early intervention services in psychosis
T2 - From evidence to wide implementation
AU - Csillag, Claudio
AU - Nordentoft, Merete
AU - Mizuno, Masafumi
AU - Jones, Peter B.
AU - Killackey, Eóin
AU - Taylor, Matthew
AU - Chen, Eric
AU - Kane, John
AU - Mcdaid, David
PY - 2015/9/11
Y1 - 2015/9/11
N2 - Aim: Early intervention (EI) in psychosis is a comprehensive and evidence-based approach aimed at detection and treatment of psychotic symptoms in their early stages. This paper presents core features and noteworthy aspects of the evidence basis and limitations of EI, the importance of programme fidelity, challenges for its widespread dissemination and economic perspectives related to it. Methods: This paper is a narrative review about the evidence supporting EI and the challenges to its widespread dissemination. Results: In spite of evidence of a wide range of benefits, widespread dissemination has been slow, and even currently implemented programmes might be threatened. This reflects in part the shortcomings of mental health care in general, such as low priority for funding, stigma and structural problems. Successful examples of advocacy, mobilization and destigmatization campaigns have overcome these difficulties. Conclusions: Funding for mental health in general and for EI services appears low relative to need. One key argument for better funding for EI can be found in its favourable cost-effectiveness, but not all stakeholders beyond mental health administrators are aware of this. Positive impacts of EI programmes on excess unemployment and tax forgone suggest that social affairs and labour ministries - and not only health ministries - could be more involved in governance of mental health issues; ministries of justice and education are other sector stakeholders than can benefit. Wider dissemination of EI services will probably benefit from better integration of potential funders, promotion of joint targets and shared financial or budgetary incentives.
AB - Aim: Early intervention (EI) in psychosis is a comprehensive and evidence-based approach aimed at detection and treatment of psychotic symptoms in their early stages. This paper presents core features and noteworthy aspects of the evidence basis and limitations of EI, the importance of programme fidelity, challenges for its widespread dissemination and economic perspectives related to it. Methods: This paper is a narrative review about the evidence supporting EI and the challenges to its widespread dissemination. Results: In spite of evidence of a wide range of benefits, widespread dissemination has been slow, and even currently implemented programmes might be threatened. This reflects in part the shortcomings of mental health care in general, such as low priority for funding, stigma and structural problems. Successful examples of advocacy, mobilization and destigmatization campaigns have overcome these difficulties. Conclusions: Funding for mental health in general and for EI services appears low relative to need. One key argument for better funding for EI can be found in its favourable cost-effectiveness, but not all stakeholders beyond mental health administrators are aware of this. Positive impacts of EI programmes on excess unemployment and tax forgone suggest that social affairs and labour ministries - and not only health ministries - could be more involved in governance of mental health issues; ministries of justice and education are other sector stakeholders than can benefit. Wider dissemination of EI services will probably benefit from better integration of potential funders, promotion of joint targets and shared financial or budgetary incentives.
KW - Early intervention in psychosis
KW - Evidence-based medicine
KW - Health planning
KW - Implementation
KW - Psychiatric service
UR - http://www.scopus.com/inward/record.url?scp=84941588194&partnerID=8YFLogxK
U2 - 10.1111/eip.12279
DO - 10.1111/eip.12279
M3 - Article
AN - SCOPUS:84941588194
SN - 1751-7885
JO - Early Intervention in Psychiatry
JF - Early Intervention in Psychiatry
ER -