From: Essential elements of an early intervention service for psychosis: the opinions of expert clinicians
Element | Grouping |
---|---|
EIS should deal with people in their first episode of psychosis | The client group |
EIS should be composed of staff whose sole or main responsibility is to the EIS | Team structure |
EIS should have at least one member trained in CBT | Team structure |
The EIS approach should incorporate medical, social and psychological models | Team structure |
The EIS should emphasise clients' views on their problems and level of functioning | Team structure |
The EIS should include a consultant psychiatrist with dedicated sessions | Membership |
The EIS should include at least one psychiatric nurse | Membership |
The EIS should include a clinical psychologist | Membership |
EIS should have support from CAMHS when prescribing for under 16 year olds | Membership |
The EIS should have close links with CAMHS | Membership |
The EIS should assess clients referred on suspicion rather than certainty of psychosis | Initial assessment |
The EIS should encourage direct referrals from primary care | Initial assessment |
The EIS should regularly audit effectiveness of referral pathways & training programmes | Initial assessment |
The EIS should offer a rapid initial assessment | Initial assessment |
An EIS assessment should include a psychiatric history and mental state examination | Initial assessment |
An EIS assessment should include an assessment of risk (including suicide) | Initial assessment |
An EIS assessment should include a social functioning and resource assessment | Initial assessment |
An EIS assessment should include an assessment of the client's family | Initial assessment |
An EIS assessment should include the client's aspirations and understanding of their illness | Initial assessment |
An EIS assessment should be multi-disciplinary | Initial assessment |
Each EIS client should have a relapse risk assessment | Initial assessment |
The EIS should have access to translation services | Initial assessment |
EIS should not be concerned about precise diagnosis so long as in psychotic spectrum | Initial assessment |
The EIS should accept referrals from child and adolescent mental health services | Initial assessment |
The goal of early contact should be engagement rather than treatment | Initial assessment |
The EIS assessment should identify areas of distress | Initial assessment |
EIS should have a assertive approach to engagning the client & their family/social network | engagement |
The EIS should not close the case if the client fails to engage | engagement |
The EIS should allocate a key worker to all clients accepted into the service | engagement |
The EIS should provide services away from traditional psychiatric settings to avoid stigma | engagement |
EIS should emphasise the identification and treatment of depression amongst its clients | Non-pharmaceutical |
EIS should emphasise the identification & treatment of suicidal thinking | Non-pharmaceutical |
The EIS should provide CBT to clients with treatment-resistant positive symptoms | Non-pharmaceutical |
Each EIS client should have a relapse prevention plan | Non-pharmaceutical |
The EIS should provide clients with educational materials about psychosis | Non-pharmaceutical |
The EIS should use low-dose atypical neuroleptics as the first line drug treatment | Pharmaceutical |
Clients with disabling negative symptoms should have review of drug treatment | Pharmaceutical |
The EIS should actively involve clients in decisions about medication | Pharmaceutical |
EIS clients should get detailed information about medication | Pharmaceutical |
The EIS should engage the client's family/significant others at an early stage | Relatives and sig others |
The EIS should involve family and significant others in the client's ongoing review process | Relatives and sig others |
The EIS should provide families with psychoeducation and support | Relatives and sig others |
The EIS should provide families with Psychoeducational Family Intervention | Relatives and sig others |
A relapse prevention plan should be shared with the client's family/significant others | Relatives and sig others |
EIS should have access to separate age-appropriate in-patient facilities for young people | Admission to Hospital |
The EIS should be able to provide intensive community support when a client is in crisis | Admission to Hospital |
Each EIS service user/family/carer should know how to access support in a crisis | Admission to Hospital |
EIS clients should be able to access out-of-hours support from a 24 hour crisis team | Admission to Hospital |
When a client is an in-patient, EIS team should be actively involved in in-patient reviews | Admission to Hospital |
When a client is an in-patient, EIS team should be actively involved in discharge planning | Admission to Hospital |
The EIS should be prepared to use its powers under mental health legislation | Admission to Hospital |
There should be a single point of contact so primary care and other agencies can check out potential concerns/resources and to ease the confusion of roles/responsibilities | Community connections |