Debate: Early Intervention for all mental disorders in all age groups would compromise the gains of decades of EI Psychosis Teams

Presentation First Author: 
Peter Byrne

Early Intervention (EI) for young people with psychosis has become the gold standard. Generic community mental health services have too many other demands made of them to deliver specialist EI to this or other groups. They provide lifetime care to people with severe mental disorders (SMI) and are the gatekeepers for new onset disorders, provided patients' symptoms reach the threshold of severity and duration. Lowering this threshold or holding cases that may not develop SMI would overwhelm services so that no group would receive adequate levels of care. If generic community teams were labelled as EI practitioners, there would be no perceived need for EI Psychosis Teams and therefore a return to 1970s community psychiatry. Meddling with EI models will compromise the gains of two decades: if it ain't broke, don't fix it. Opposing the motion are the editors of a 2014 book that advocates an ambitious roll out of EI. Building on the work of EI pioneers, they use examples across every age group and most mental health disorders and services to make EI a key component of 21st mental health care. Accumulating evidence will persuade clinicians, purchasers of services and others to the high value of EI from cradle to grave. EI services for psychosis should remain as discrete teams but EI service teams for other disorders should also be developed. We advocate discrete fidelity criteria and evidence of effectiveness of a specific, specialized team approach.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Paddy Power - David Meagher - Alan Rosen
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