The Psychiatrist (2009) 33: 165-168. doi: 10.1192/pb.bp.108.019646
© 2009 The Royal College of Psychiatrists
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First-episode psychosis: primary care experience and implications for service development

Mamdouh EL-Adl, Consultant Psychiatrist

*Campbell House, Campbell Square, Northamptonshire Healthcare NHS Trust, Northampton NN1 3EB, email: mamdouhkandil{at}doctors.org.uk

John Burke, Consultant Psychiatrist

Northamptonshire Healthcare NHS Trust, Northampton

Karen Little, Clinical Governance and Professional Development Manager

Preston Primary Care Trust, Preston

Declaration of interest

None.

AIM AND METHODS

To capture the local primary care experience of first-episode psychosis before developing a local early intervention in psychosis service. A survey of Northamptonshire general practitioners (GPs) using a confidential questionnaire was carried out.

RESULTS

Out of 284 GPs, 123 (43%) responded. General practitioners are unlikely to start treatment before referring to a specialist service: 63 GPs (51% of responders) start treatment in 10% or less of individuals with first-episode psychosis and 19 (15.5%) GPs start treatment in 75% or more before referring them to psychiatric service; 42 GPs (34%) refer those who request/accept a referral and 66 GPs (53%) refer all even if they refuse. Overall, 92 GPs (74%) agreed that an early intervention in psychosis service is needed and 77 (63%) GPs welcome having a mental health clinic in their surgery.

CLINICAL IMPLICATIONS

Individuals are more likely to accept referral to a psychiatric service if offered than to ask for it. People disengaging, stigma, the service being difficult to access/inappropriate and carers’ lack of knowledge about mental illness are the likely causes for delayed referral.




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A. Bowers
General practitioners and early intervention in psychosis
The Psychiatrist, August 1, 2009; 33(8): 314 - 314.
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M. EL-Adl, J. Burke, and K. Little
General practitioners and early intervention in psychosis: reply
The Psychiatrist, August 1, 2009; 33(8): 314 - 315.
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eLetters:

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GP's and early intervention in psychosis
Dr Alexis Bowers
The Psychiatrist Online, 12 May 2009 [Full text]
Re: GP's and early intervention in psychosis
Mamdouh EL-Adl, et al.
The Psychiatrist Online, 25 May 2009 [Full text]