“The National Policy Reforms for Mental Health Services and the Story of Early Intervention Services in the United Kingdom.” By Renju Joseph, University of Birmingham. IN: Journal of Psychiatry & Neuroscience, vol. 30, no. 5 (September 2005) pp. 362-365.

[“In this review, we summarize and review reforms to the mental health service in the United Kingdom from 1999 to the present. Our analysis is based on government documents describing the reforms and providing guidelines for their implementation. In addition, we summarize prospective studies of psychosis from the first episode and early treatment studies on the basis of existing systematic reviews. The UK mental health reforms have attracted major government funding and have been used to commission specialized ‘functional’ community teams for people with severe mental illness. The reforms include changes to services for first-episode psychosis, which have attracted considerable consumer support. The UK service reforms are continuing, with the aim of providing services fit for the 21st century.”]

[Request #S705118]

“Pathways to Care in First Episode Psychosis: A Pilot Study on Help-Seeking Precipitants and Barriers to Care.” By Abigail M. Judge, University of North Carolina at Chapel Hill, and others. IN: Journal of Mental Health, vol. 14, no. 5 (October 2005) pp. 465-469.

[“It is well documented that individuals experiencing first episode (FE) psychosis encounter significant delays in obtaining appropriate treatment, but why this occurs remains poorly understood. Aims: To examine the duration of untreated psychosis in a FE population, to describe precipitants of help-seeking attempts, and to identify barriers to obtaining appropriate treatment. Methods: Twenty individuals who recently received antipsychotic treatment for a FE of psychosis were interviewed about help-seeking behaviors. Results: A total of 75 help-seeking attempts were reported. Fifty percent of the sample reported aggressive behaviors toward the self or others prior to obtaining treatment. Patients and their families experienced significant delays in linking with appropriate psychiatric care. The most common barrier to treatment was a failure to recognize the seriousness of behavioral changes as part of a mental illness. Conclusions: Further investigations on treatment delay that highlight barriers to care and emphasize the patient's perspective are warranted.”]

[Request #S705120]

“Preventing EPISODE II: Relapse Prevention in First-Episode Psychosis.” By John Gleason, University of Melbourne. IN: Australasian Psychiatry, vol. 13, no. 4 (December 2005) pp. 384-387.

[“Objective: This paper outlines a rationale for expanding research and clinical innovations focused upon relapse prevention following a first episode of psychosis. Some general principles for further progress are extracted from an overview of the first-episode psychosis (FEP) relapse literature. A cognitive behaviour therapy intervention for relapse prevention for FEP, that has been developed at the Early Psychosis Prevention and Intervention Centre, is described to illustrate these principles. Conclusions reached are that further progress is needed in refining interventions specific to the prevention of relapse following FEP. Future progress is dependent upon improved understanding of the interaction of biological, interpersonal and psychological processes underpinning relapse.”]

[Request #S705121]

“Psychosocial Treatment for First-Episode Psychosis: A Research Update.” By David L. Penn, University of North Carolina-Chapel Hill. IN: The American Journal of Psychiatry, vol. 162, no. 12 (2005) pp. 2220-2232.

[“This article reviews research on psychosocial treatment for first-episode psychosis. Method: PsycINFO and MEDLINE were systematically searched for studies that evaluated psychosocial interventions for first-episode psychosis. Results: Comprehensive (i.e., multi-element treatment approaches show promise in reducing symptoms and hospital readmissions, as well as improving functional outcomes, although few rigorously controlled trials have been conducted, individual cognitive behaviour therapy has shown modest efficacy in reducing symptoms.” NOTE: The American Journal of Psychiatry is available for loan.}

[Request #S705122]

“Treating First Episode Psychosis – The Service Users’ Perspective: A Focus Group Evaluation.” By M. S. O’Toole and others. IN: Journal of Psychiatric and Mental Health Nursing, vol. 11 (2004) pp. 319-326.

[“UK national guidance has prioritized developing specialist services for first episode psychosis. Such services are in the early stages of development and a definitive treatment model has yet to be established. The aim of this study was to explore service users’ experience of a first episode intervention designed along evidence-based ‘best practice’ guidelines and to establish specific elements seen as effective to help inform future service planning and provision…. Key elements identified by the service users included the ‘human’ approach as a key to the recovery process, being involved in treatment decisions, flexibility of appointments, high nurse to patient ratio, reduction in psychotic symptoms, increased confidence and independence and the provision of daily structure. To our knowledge, this is the first systematic qualitative evaluation of users’ experience of a specialist first episode treatment intervention. Our findings indicate that adherence to best practice guidelines was appreciated. Regular focus groups provide a continuous audit cycle incorporating service improvements in line with government recommendations, centrally informed by the service users’ and caregivers’ perspective.”]

[Request #S705123]