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Special Interest Group For Early Intervention
- Mark Agius, Brian Martindale, Iftikhar Ahmad , Debasis Das, Vimal Sharma, Swaran Singh, Prof Max Marshall, Eileen O’Regan, David Orton, Rashid Zaman. (1 February 2006)
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Mark Agius, Associate Specialist Early Intervention Team Luton., Brian Martindale, Iftikhar Ahmad , Debasis Das, Vimal Sharma, Swaran Singh, Prof Max Marshall, Eileen O’Regan, David Orton, Rashid Zaman.
Send letter to journal:
mark.aguis{at}blpt.nhs.uk Mark Agius, et al.
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Dear Sir, Garety et al are to be congratulated on their findings that social and clinical outcomes in first episode psychosis are better in an Ad Hoc Early Intervention Service than in a standard CMHT. [Garety 2006]. These findings contribute to the growing volume of evidence that the present DOH Policy to implement Early Intervention Services across the United Kingdom by December 2006 is a wise one [Craig2004] [Petersen 2005][Cullberg 2002] The overall implications of this long term nationwide development have considerable implications for the training of doctors who are to work in Early Intervention Teams. Such doctors will need to have sufficient training to be fully supportive of the development of a range of psychosocial intervention skills within the teams to match the needs of the wide variety of people and problems of such patients. The sub-categorisation of psychosis is not a reliable clinical tool during the first episode [McGorry 1995], but a capacity to elicit the qualitative and quantitative nature of the individual’s stress and vulnerability will be an important assessment tool, highly relevant to the rehabilitation over the subsequent three years in the service. There are considerable training implications from the fact that the age range of patients in the teams is 14-35 years and the average will be somewhere around 22. In order that Early Intervention teams are fully enabled by psychiatric members it is now time for the College to move to ensuring appropriate training experience is defined for Consultants and Associate Specialists in such teams. At the recent meeting of the RCPsych Faculty of General and Community Psychiatry in Liverpool last October, it was proposed that the College might move towards the formation of a Special Interest Group for Doctors working in Early Intervention services. An important function of this group would be the setting of Training Standards for doctors in EIP. A second role for such a group is to develop guidelines for the role of doctors in such teams including their involvement in complex diagnostic issues, the interaction of the EIP teams with other important services including other new teams, and guidelines for the development of working paradigms within teams. A further consideration is that trainee psychiatrists will no longer be involved in the treatment of first episode cases unless they gain experience of early intervention teams. It will be vital for the consultants of tomorrow of other services to become familiar with first episode paradigms, especially as a number service improvements incorporated into EIP will need to be incorporated into the longer-term care of those 40% of EIP patients who may need longer term therapeutic care beyond the up to three years that patients spend in EIP teams [Falloon 2004] . We already have 30 names of persons interested in joining an informal group who will be working up formal proposals for the College and would like to hear from others interested. Ref. Craig TJ, 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, Levander S, HolmquistR et al [2002] One year outcome in first episode psychosis in patients in the Swedish Parachute project. Acta Psychiatrica Scandinavica 106,276-285. Falloon IRH et al [2004] Implementation of evidence-based treatment for schizophrenic disorders; two-year outcome of an international field trial of optimal treatment. World Psychiatry 3;104. McGorry PD,Mihalopoulos C, Henry L , et al [1995] Spurious precision;Procedural validity of diagnostic assessment in psychotic disorders. Am J Psychiatry 152;220-223. Petersen L, JeppesenP, 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. |
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