Claudio Csillag1, Merete Nordentoft2, Masafumi Mizuno3, Peter B Jones4, Eóin Killackey5, Matthew Taylor6, Eric Chen7, John Kane8, David McDaid9. 1. Mental Health Centre North Zealand, University of Copenhagen, Copenhagen, Denmark. claudio.csillag@regionh.dk. 2. Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark. 3. Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan. 4. Department of Psychiatry, University of Cambridge, Cambridge, UK. 5. Orygen, The National Centre of Excellence in Youth Mental Health and The Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia. 6. Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK. 7. Department of Psychiatry, University of Hong Kong, Hong Kong. 8. Department of Psychiatry, Hofstra North Shore-Long Island Jewish School of Medicine, Hempstead, New York, USA. 9. Health and Social Care, London School of Economics and Political Science, London, UK.
Abstract
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.
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.
Authors: James B Kirkbride; Yasir Hameed; Gayatri Ankireddypalli; Konstantinos Ioannidis; Carolyn M Crane; Mukhtar Nasir; Nikolett Kabacs; Antonio Metastasio; Oliver Jenkins; Ashkan Espandian; Styliani Spyridi; Danica Ralevic; Suneetha Siddabattuni; Ben Walden; Adewale Adeoye; Jesus Perez; Peter B Jones Journal: Am J Psychiatry Date: 2016-10-24 Impact factor: 18.112
Authors: Elizabeth C Thompson; Nicole D Andorko; Pamela Rakhshan Rouhakhtar; Zachary B Millman; Kristin Sagun; Susan C Han; Doha Chibani; Gloria M Reeves; Bruce Herman; Jason Schiffman Journal: J College Stud Psychother Date: 2020-09-04
Authors: Nev Jones; Sarah Kamens; Oladunni Oluwoye; Franco Mascayano; Chris Perry; Marc Manseau; Michael T Compton Journal: Psychiatr Serv Date: 2021-01-12 Impact factor: 4.157
Authors: Nicole D Andorko; John Fitzgerald; Caroline Roemer; Eric Solender; Emily Petti; Pamela Rakhshan Rouhakhtar; Karen E McNamara; Melissa E Smith; Robert W Buchanan; Jason Schiffman; Jordan DeVylder Journal: Early Interv Psychiatry Date: 2021-05-24 Impact factor: 2.732