Initiatives to reduce dup: what works?

Presentation First Author: 
Max Birchwood

There have been a number of initiatives to reduce DUP in first episode psychosis. In this paper we present the findings of a systematic review by Lloyd-Evans et al (2010, British Journal of Psychiatry). Efforts to replicate the Norwegian TIPS findings have met with mixed results. We argue that this is may be due to the impact of different care pathways within different healthcare systems, which require a tailored approach. We illustrate this with the findings of the REDIRECT trial of training GPs in early recognition and fast access to early intervention services (Lester et al, 2010) which found no effect on reducing DUP because the most of the delay occurred within the mental health system. Interventions to reduce DUP need first to establish at what point(s) in the care pathway delays occur, especially for the DUP 'outliers'; and, especially in multi-cultural contexts, the different help-seeking pathways.

Conference Name: 
Presentation Date: 
January, 2013
Additional Authors: 
Max Birchwood, Bryn Lloyd-Evans
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