Reducing DUP in first-episode psychosis requires a detailed understanding of care pathways in community and mental health service settings: data from Birmingham UK

Presentation First Author: 
Charlotte Connor

This study described in this paper has two aims. First to understand the delays in the care pathway for first episode psychosis in a large multicultural city in the UK. Second, to target these delays in a public health intervention.DUP data from the Birmingham lead site of the National EDEN cohort study were analysed. One third of the sample were identified with a DUP exceeding 6 months, which previous findings suggest is the critical point at which full recovery is impeded. Analysis of the components of DUP revealed the greatest contribution to DUP in this group came from delays experienced within mental health services, followed by help-seeking delays. Modelling the impact of reducing these component delays showed that both mental health service delay and help seeking delay would have to be reduced to at least 60 and 90 days respectively to significantly impact on the proportion with DUP > 6 months. Care-pathways which involved generic Community Mental Health Teams were associated with longer DUP due to poor engagement of young people with psychosis; care pathways involving direct access to early intervention services led to much reduced DUP. Interviewing carers and patients showed that long help-seeking delays arising due to lack of knowledge about psychosis, fear and stigma. Help-seeking was most commonly initiated by family or friends. We describe a pilot public health intervention in Birmingham UK to reduce DUP, focusing on changing these two critical pathways: access to services and within the mental health service. Preliminary findings will be presented

Conference Name: 
Presentation Date: 
January, 2013
Additional Authors: 
Charlotte Connor, Max Birchwood, Helen Lester, Swaran Singh, Paul Patterson, Colin Palmer, Sarah Butterworth
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