Early Intervention in Psychosis

Scope of the National Clinical Programme

Psychosis is a condition that affects the way the brain processes information. The term ‘psychosis’ covers a range of symptoms where a person’s beliefs, thoughts, feelings, perceptions or behaviours are affected. A person with psychosis might misinterpret or confuse what’s going on around them. They might find it difficult to distinguish what’s real. An episode of psychosis can be distressing and confusing for someone who doesn’t know what’s going on. The earlier someone with psychosis gets help, the better their chances of recovery are. With the right help, most people recover and many people never experience another episode of psychosis. 

Psychosis typically has its onset in an individual’s late teens or early twenties. There are often long delays between people starting to experience symptoms and accessing mental health care (average of 2 years delay). The longer the delay between onset of symptoms and accessing mental health care the worse the outcome. In the absence of an Early Intervention in Psychosis (EIP) service, access to treatment is often in crisis and limited to medication. Outside of EIP services access to evidence based psychosocial interventions can be challenging, for example cognitive behavioural therapy (CBT) for psychosis, family interventions, education and employment supports, physical health monitoring and support. 

20 years of international data now demonstrate that EIP Services improve service users outcomes, reduce relapses, reduce requirement for hospital admission at first presentation and later, reduce suicide rates and increase retention in education and work. EIP is an ‘Invest to Save’ Clinical Programme. Each €1 invested in EIP results in €18 saving to the health service by reducing admissions, reducing relapses, reducing crisis presentations and increasing retention in employment and education. 

The Irish Early Intervention in Psychosis Clinical Programme published its Model of Care in May 2019. This Model of Care sets out a 3-year programme, which addresses three key areas: 

  1. Reduce delays in accessing specialist care: Increase community education and awareness - GPs, schools. Ensure access to expert assessment within 72 hours. 
  2. Increase access to the full range of evidence based interventions: Medication, Cognitive Behavioural Therapy for psychosis, Behavioural Family Therapy, Individual Placement Support (Employment and Education support) and Physical Health Monitoring and Support. 
  3. Ensure assertive, patient centred, recovery oriented care. Each person with psychosis is assigned to an EIP Key worker who collaborates with them, their family or supporters, the EIP team, the GP and other professionals to coordinate care and support recovery. 

The EIP key worker and the Early Intervention in Psychosis team works with the individual and their families for three years to instil hope and support each individual in their path of recovery. Supporting people to find personal recovery. 

Currently there are five EIP teams in Ireland. With plans for ongoing investment over the coming years to ensure everyone presenting for the first time with psychosis in Ireland gets access to an EIP team. An additional 20 EIP teams will be required to achieve this. All clinical programmes are dependent on new additional funding to be implemented fully and programmes can take a number of years to be fully implemented.

Video

The National Clinical Lead for Psychosis explains the Programme and the importance of early intervention. An actor from UCC Drama Society recounts the story of a young person experiencing psychosis for the first time, being frightened, accessing specialist psychosis service and beginning the road to recovery and returning to college. Names and dates have been changed.

Contact Details

National Clinical Lead:Dr. Karen O'Connor
Programme Manager:Ms. Rhona Jennings
Email:rhona.jennings@hse.ie