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Initial treatment phase in early psychosis: can intensive home treatment prevent admission?

CORE (British Psychological Society), SubDepartment of Clinical Health Psychology, University College London and Camden and Islington Mental Health and Social Care NHS Trust

Paul Bebbington, Head of Department

Department of Mental Health Sciences, Royal Free and University College London Medical School and Camden and Islington Mental Health and Social Care NHS Trust

Mark Hinton, Consultant Clinical Psychologist

Camden and Islington Mental Health and Social Care NHS Trust

Sonia Johnson, Senior Lecturer in Social and Community Psychiatry

Camden and Islington Mental Health and Social Care NHS Trust and Department of Mental Health Sciences, Royal Free and University College London Medical School, Wolfson Building, 48 Riding House Street, London W1W 7EY, e-mail: s.johnson{at}ucl.ac.uk

Declaration of interest

The authors are employed by Camden and Islington Mental Health and Social Care NHS Trust who funded the study.

AIMS AND METHOD

The aim of this study was to describe the early treatment phase in first-episode psychosis in an area with well-established crisis resolution teams. Socio-demographic characteristics and patterns of initial treatment were investigated for all individuals with first-episode psychosis identified prospectively over a 1-year period in two London boroughs.

RESULTS

Over a year, 111 people presented with first-episode psychosis. Fifty-one people (46%) were initially managed in the community, with the remaining 60 (54%) admitted to in-patient units immediately. By 3 months after presentation, a total of 80 people (72%) had been admitted and 54 (49%) had been compulsorily detained under the Mental Health Act 1983. Thirty-three people were initially managed by the crisis resolution teams and 15 of these were eventually admitted.

CLINICAL IMPLICATIONS

In a catchment area in which alternatives to admission are well developed, the admission rate for first-episode psychosis was still high.

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