Early psychosis treatment in an integrated model within an adult mental health service
Abstract
Objective: To compare the treatment of patients with early psychosis, 2 years after the introduction of an integrated model of enhanced management within a public adult mental health service, with an historic cohort from the same service. Method: Variables examined in the 2001 cohort were compared with 2008 patients. Computer database review and a file audit were conducted for all patients with early psychosis across the first 2 years of the program. Results: Compared to the historic cohort, patients in the current cohort were 24% less likely to have been admitted (P = 0.004). There were statistically significant reductions in involuntary status and use of a locked unit. Rates of police involvement in admission and use of seclusion were also reduced, though this trend was not significant. Average length of stay was reduced. Median duration of untreated psychosis was 3 months in both 2001 and 2008 cohorts. Conclusions: The introduction of an integrated model of management within an area mental health service for patients with early psychosis contributed to significant reductions in admissions, involuntary status and use of a locked ward. The data suggests that enhanced treatment of early psychosis patients can be offered within generic services.
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In the integrated model, police could become involved in the voluntary or involuntary admission process of people with mental ill health into the Early Psychosis Programme.
“One article reported an Early Psychosis Programme from Australia.39 In this model, police could become involved in the voluntary or involuntary admission process of people with mental ill health into the Early Psychosis Programme.”
From Interagency collaboration models for people with mental ill health in contact with the police: a systematic scoping review (2018) · cites this paper as [39]
Cites
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Measures to Avoid Coercion in Psychiatry and Their Efficacy.
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“Among these outcomes, a decrease in potentially traumatic experiences, such as police referrals, 40 admissions in locked units, 51 or admissions under the Mental Health Act, 50 could be beneficial, as childhood and adult adversities have shown to be associated with increased psychotic symptoms in…”
BackgroundParker, A., Scantlebury, A., Booth, A., MacBryde, J. C., Scott, W. J., Wright, K., & McDaid, C. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-019312 · Cited by 62 · see citing works
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Early intervention in psychosis: evidence, evidence gaps, criticism, and confusion
Yung, A. (2012) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1177/0004867411432205 · Cited by 35 · see citing works
Truth and reality in early intervention
McGorry, P. (2012) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1177/0004867412442172 · Cited by 34 · see citing works
“Castle appears to agree that reduction of DUP is worthwhile, since he and coauthors express concern that in their service they have not only failed to reduce median DUP, but that the mean has increased to a staggering two years, as bad as a recorded anywhere in the world (Petrakis et al., 2011).”
BackgroundSelvendra, A., Baetens, D., Trauer, T., Petrakis, M., & Castle, D. (2014) · Australasian Psychiatry · doi:10.1177/1039856214532558 · Cited by 33 · see citing works
Self-citationPetrakis, M., & Laxton, S. (2017) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2016.07.015 · Cited by 27 · see citing works
Self-citationBehan, C. L., Masterson, S., & Clarke, M. (2016) · Early Intervention in Psychiatry · doi:10.1111/eip.12334 · Cited by 26 · see citing works
“There were further studies that evaluated different service models that ultimately were not included in the final review as they were not limited to people within their first year of psychosis; however, they are described in the discussion.(24,33) Quantitative evaluation could not be performed because of the heterogen…”
MethodResultPenno, S., Hamilton, B., & Petrakis, M. (2017) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2017.07.003 · Cited by 13 · see citing works
“This paper examined the outcomes of an EP population within an integrated EPP, with key nursing roles in place across inpatient and community settings, as described in a previous publication (Petrakis et al., 2012).”
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Prevalence and clinicians’ awareness of psychiatric comorbidities among first–episode schizophrenia
Siu, M.-W., Chong, C., & Lo, W. (2018) · Early Intervention in Psychiatry · doi:10.1111/eip.12426 · Cited by 9 · see citing works
Ly, A., Tremblay, G., & Beauchamp, S. (2019) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462319000084 · Cited by 9 · see citing works
“The programs studied were OPUS in Denmark (25); Lambeth Early Onset (LEO) in England (26), Programma 2000 in Italy (27), Parachute in Sweden (28) PEPP in Canada (29), PEP in Australia (30), Early Treatment and Home-based Outreach Service (ETHOS) in England (31) and a program from Norway (32).”
BackgroundVocational support in mental health service delivery in Australia
Petrakis, M., Stirling, Y., & Higgins, K. (2018) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2018.1498918 · Cited by 8 · see citing works
“Data was extracted by a representative of the Data Management Unit from Client Management Interface (CMI) and Medical Records Online (MRO) client information management databases utilising a coding system that had been previously generated for an earlier descriptive study [20].”
MethodSelf-citationWhat, after all, is the truth: Response to McGorry
Castle, D. (2012) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1177/0004867412449297 · Cited by 6
“Actually, we set up an early psychosis initiative within our service (an integrated model, accessible to anyone, not sim ply youth) out of existing funds, as part of what we see as a comprehen sive service approach (Petrakis et al., 2011).”
BackgroundSelf-citationBērze, L., Civcisa, S., Krone, I., Kvartalovs, D., Ķikuste, S., Šapele, I., Lazovika, J., & Rancāns, E. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00829 · Cited by 5 · see citing works
“There is an opinion in the literature that patients with psychosis are in a patient group with specific needs (14, 18) based on the fact that the LAT-EIP is the first specialized program for patients with psychosis in Latvia.”
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Early Intervention for Young People with Mental Illness
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Longitudinal Diagnostic Reassessment of Schizoaffective Disorder in Chronic Psychosis: A Case Report
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Modelling Target Workforce Estimates For Community-Based Mental Health Services In LebanonPreprint
Kheir, W., Zoghbi, E., Bteich, R., Rady, A., & Chammay, R. E. (2021) · Research Square · doi:10.21203/rs.3.rs-1192774/v1 · Cited by 1 · see citing works
“Page 4/16 The model consists of seven steps: (1) estimating the current mental health workforce; (2) estimating the need for mental health services for the eight disorders; (3) estimating the prevalence of the eight priority disorders; (4) setting treatment coverage targets for each of the eight disorders; (5) setting…”
BackgroundStimulant use disorders and psychosis: prevalence, correlates and impacts
Sara, G. E. (2014) · The University of Queensland · doi:10.14264/uql.2015.15 · Cited by 1 · see citing works
“These are not novel messages in Australian healthcare: many state and territory specialist mental health services have implemented reforms of this type (New South Wales Health Department, 2001; Petrakis et al., 2012; Preston et al., 2003), and model youth and early intervention services developed in the state of Victo…”
BackgroundChee, G.-L., Wynaden, D., & Heslop, K. (2020) · Issues in Mental Health Nursing · doi:10.1080/01612840.2020.1797251
Early intervention in psychosis: Evidence, evidence gaps, criticism and confusion
Baetens, D., Penno, S., Dowling, J., Petrakis, M., & Castle, D. (2012) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1177/0004867412449063
“These data (Petrakis et al., 2011a) were derived from a comprehensive audit, conducted on all patients identified as having early psychosis who were within their first 2 years of treatment in a program that serviced patients aged 16 to 64 years.”
MethodResultSelf-citation
- Authors
- Petrakis, M., Penno, S., Oxley, J., Bloom, H., & Castle, D.
- Affiliations
- Monash University (AU)
- The University of Melbourne (AU)
- Corresponding author
- Petrakis, M.
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-10
- Volume
- 27
- Issue
- 7
- Pages
- 483-488
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- OpenAlex
- W2049885208
- Cited by
- 26
- References
- 0
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 4 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 3 · 2012: 4
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (University of Western Australia) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Keywords
- early psychosis, integrated care model, adult mental health services, hospitalization, involuntary admission, locked wards, seclusion, police involvement, length of hospital stay, duration of untreated psychosis
- MeSH terms
- Adult, Catchment Area, Health, Humans, Length of Stay, Mental Health Services, Psychotic Disorders, Databases, Factual, Treatment Outcome
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