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Early intervention in psychosis service and psychiatric admissions

  • Guy Dodgson (a1), Kathleen Crebbin (a2), Caroline Pickering (a2), Emma Mitford (a3), Alison Brabban (a4) and Roger Paxton (a5)...
Abstract
Aims and Method

To investigate the effects of a standard National Health Service early intervention in psychosis service on bed days and engagement with services. We conducted a naturalistic before-and-after study comparing outcomes of individuals who received treatment from the service (n=75) with outcomes of individuals who presented to mental health services before the early intervention service was established and received treatment as usual (n=114).

Results

People treated by the early intervention in psychosis service had significantly fewer admissions (P < 0.001), readmissions (P < 0.001), total bed days (P < 0.01) and better engagement with services (P < 0.05).

Clinical Implications

An early intervention in psychosis service compliant with current British mental health policy led to reduced use of psychiatric bed days confirming recent findings elsewhere. This leads to major financial savings, easily justifying the initial cost of investment in the service.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Abas, M., Vanderpyl, J., Le Prou, T., et al (2003) Psychiatric hospitalization: reasons for admission and alternatives to admission in South Aukland, New Zealand. Australian and New Zealand Journal of Psychiatry, 37, 620625.
Craig, T.K.J., Garety, P., Power, P., et al (2004) The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ, 329, 1067.
Cullberg, J., Mattsson, M., Levander, S., et al (2006) Treatment costs and clinical outcome for first-episode schizophrenia patients: a 3-year follow-up of the Swedish ‘Parachute Project’ and two comparison groups. Acta Psychiatrica Scandinavica, 114, 274281.
Dean, C. & Gadd, E. (1990) Home treatment for acute psychiatric illness. BMJ, 301, 10211023.
Department of Health (2001) Mental Health Policy Implementation Guide. Department of Health.
Farina, A., Garmezy, N. & Barry, H. (1963) Relationship of marital status to incidence and prognosis of schizophrenia. Journal of Abnormal and Social Psychology, 67, 624630.
Garety, P. A., Craig, T. K. J., Dunn, G., et al (2006) Early intervention has no effect on symptoms in people with first episode, non-affective psychosis, although it may improve overall function and medication adherence. British Journal of Psychiatry, 188, 3745.
Glover, G., Arts, G. & Babu, K. S. (2006) Crisis resolution/home treatment teams and psychiatric admission rates in England. British Journal of Psychiatry, 189, 441445.
Goldberg, K., Norman, R., Hoch, J., et al (2006) Impact of a specialised early intervention service for psychotic disorders on patient characteristics, service use, and hospital costs in a defined catchment area. Canadian Journal of Psychiatry, 51, 895903.
Guo, S., Biegel, D., Johnsen, J., et al (2001) Assessing the impact of community-based mobile crisis services on preventing hospitalisation. Psychiatric Services, 52, 223228.
Jablensky, A., Sartorius, N., Ernberg, G., et al (1992) Schizophrenia: manifestations, incidence and course in different cultures: A World Health Organization ten-country study. Psychological Medicine Monogram Supplement, 20, 197.
Lay, B., Lauber, C. & Rossler, W. (2006) Prediction of in-patient use in first-admitted patients with psychosis. European Psychiatry, 21, 401409.
Marshall, M. & Rathbone, J. (2006) Early intervention for psychosis. Cochrane Database of Systematic Reviews, 4, CD004718.
McCrone, P. & Knapp, M. (2007) Economic evaluation of early intervention services, British Journal of Psychiatry, 191 (suppl. 51), S19S22.
Morrison, A. P., Frame, L. & Larkin, W. (2003) Relationship between trauma and psychosis: a review and integration. British Journal of Psychiatry, 42, 331353.
Murray, R. M. & Van Os, J. (1998) Predictors of outcome in schizophrenia. Journal of Clinical Psychopharmacology, 18 (2 suppl. 1), 2s4s.
Paxton, R., Chaplin, L., Selman, M., et al (2003) Early intervention in psychosis: a pilot study of methods to help existing staff adapt. Journal of Mental Health, 12, 627636.
Pelosi, A. & Birchwood, M. (2003) Is early intervention for psychosis a waste of valuable resources? British Journal of Psychiatry, 182, 196198.
Petersen, L., Jeppensen, P., Thorup, A., et al (2005) A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness. BMJ, 331, 602.
Proctor, S. E., Mitford, E. & Paxton, R. (2004) First episode psychosis: a novel methodology reveals higher than expected incidence; a reality-based population profile in Northumberland, UK. Journal of Evaluation in Clinical Practice, 10, 539547.
Schnyder, U., Klaghofer, R., Luethold, A., et al (1999) Characteristics of psychiatric emergencies and the choice of intervention strategies. Acta Psychiatrica Scandinavica, 99, 179187.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Early intervention in psychosis service and psychiatric admissions

  • Guy Dodgson (a1), Kathleen Crebbin (a2), Caroline Pickering (a2), Emma Mitford (a3), Alison Brabban (a4) and Roger Paxton (a5)...
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eLetters

Not quite as simple as this

LS Choong, Medical director
19 December 2008

The cash saved following a reduction of bed days claimed by Dodgson et al needs tobe understood in the context of benefits realisation and clinical service realities. The average bed reduction was just over four. Therefore it would not reduce costs of the admission ward if the beds were filled up by others. Further, keeping the beds empty would not allow the full savings tobe achieved as the corresponding reduction in staff would not usually possible in practice; the overheads would also, by and large, remain the same.

Savings near this level, apart from central organisational overheads,can however be achieved if whole wards can be closed. This requires the right critical mass in terms of reduction in bed usage through services providing for bigger populations or being part of a raft of other interventions such as assertive outreach, day service provisions, crisis reslution and home treatment.
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Conflict of interest: None Declared

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