The British Journal of Psychiatry (2009) 194: 446-450. doi: 10.1192/bjp.bp.108.053587
© 2009 The Royal College of Psychiatrists
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Development and implementation of early intervention services for young people with psychosis: case study

Helen Lester, MBBCh

National Primary Care Research & Development Centre, Manchester

Max Birchwood, DSc

School of Psychology, College of Life and Environmental Science

Stirling Bryan, PhD

Health Services Management Centre, University of Birmingham

Elizabeth England, MBBS, Helen Rogers, PhD and Namita Sirvastava, MSc

Department of Primary Care, College of Medical and Dental Sciences, University of Birmingham, UK

Correspondence: Professor Helen Lester, National Primary Care Research & Development Centre, 5th Floor Williamson Building, Oxford Road, Manchester M13 9PL, UK. Email: Helen.lester{at}manchester.ac.uk

Declaration of interest

None.

Funding

This study was funded by the National Institute for Health Research Service Delivery and Organisation Programme. H.L. is the guarantor of the paper. M.B. was joint grant holder. S.B. was a grant holder. H.L. is independent from the funding body and the views expressed in this paper have not been influenced by the funding source.

Background

The development of early intervention services for young people with first-episode psychosis is a priority internationally.

Aims

To evaluate the development, implementation and impact of existing and newly formed early intervention services in England.

Method

Multiple-case study involving staff, users, carers and commissioners of 14 early intervention services.

Results

Service numbers increased in response to national policy directives. They were still actively working with 90.6% of service users 12 months after inception. They were highly valued by users and carers as providing a personal service that contrasted with previous experiences of care. Tensions between providing a quality service and meeting case-load targets linked to future funding led teams to adopt a series of survival strategies with some unintended consequences.

Conclusions

Early intervention services are highly valued by consumers and engage users effectively after 12 months. Implementation of these services is threatened unless sufficient consistent funding is made available.


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