Retrospective study of a first-episode psychosis service embedded within a home-based treatment team

Ir J Psychol Med. 2019 Dec;36(4):265-269. doi: 10.1017/ipm.2019.15. Epub 2019 May 27.

Abstract

Objectives: To evaluate if having an early intervention service (EIS), which is embedded within a home-based treatment team (HBTT), is associated with (1) shorter duration of untreated psychosis (DUP), (2) lower rates of hospital admissions at first presentation, (3) a lesser number of hospital admissions within 6 months of presentation and (4) a reduced mean bed usage for the first 6 months.

Methods: The files of those who presented with a first-episode psychosis (FEP) to the South Lee Mental Health Service from January 2016 to February 2017 were identified and a retrospective case review was carried out. The demographics, clinical characteristics and hospital admissions were compared for those admitted to either the EIS or community mental health teams.

Results: Forty patients were assessed. DUP was found to be longer for those who presented to the EIS (U = 121, p = 0.03). There were fewer admissions at first presentation (χ2 (1) = 6.51 p = 0.01), fewer admissions within the first 6 months of presentation (χ2 (1) = 5.56 p = 0.02) and less bed usage overall (U = 131, p = 0.047) for those who presented to the EIS.

Conclusion: The study provides a baseline clinical and demographic profile of patients with FEP in an Irish mental health service and demonstrates current pathways to care. EIS embedded within an HBTT was associated with fewer hospital admissions and less bed usage. It is unclear whether these findings may have occurred due to the EIS or due to the benefits provided by an HBTT.

Keywords: Early intervention; first-episode psychosis; patient outcome assessment; service development.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Community Mental Health Centers / statistics & numerical data
  • Demography
  • Duration of Therapy
  • Early Medical Intervention / trends*
  • Episode of Care
  • Female
  • Home Care Services, Hospital-Based / organization & administration*
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Mental Health Services / statistics & numerical data
  • Patient Outcome Assessment
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / therapy*
  • Residential Treatment / organization & administration*
  • Retrospective Studies