Can targeted early intervention improve functional recovery in psychosis? A historical control evaluation of the effectiveness of different models of early intervention service provision in Norfolk 1998-2007

Early Interv Psychiatry. 2009 Nov;3(4):282-8. doi: 10.1111/j.1751-7893.2009.00146.x.

Abstract

Aims: This paper assesses the impact of different models of early intervention (EI) service provision on functional recovery and inpatient hospital admission. The study compares the outcome of a comprehensive EI team with a partial model (community mental health team (CMHT) plus specialist support) and traditional care (generic CMHT) over a 10-year period.

Methods: The design is in comparison with historical control. The study compares the functional recovery outcomes of three cohorts from the same geographical area over the period 1998-2007. The primary outcomes were partial and full functional recovery defined with respect to readily identifiable UK benefit system thresholds and psychiatric inpatient admission days at 1 and 2 years post-referral.

Results: Only 15% of individuals made a full or partial functional recovery at 2 years under the care of a traditional generic CMHT in 1998. In 2007, 52% of the cases were making a full or partial functional recovery under the care of the comprehensive EI team. A large reduction in inpatient admissions was associated with the EI strategy.

Conclusions: The implementation of comprehensive EI teams can have a major impact in improving functional recovery outcomes in psychosis and reducing inpatient admissions. Partial implementation using limited funding of specialist workers in collaboration with traditional care appeared to have a more limited effect on these recovery dimensions. The implementation of targeted EI in psychosis strategies can result in substantive functional benefits.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Community Mental Health Services / statistics & numerical data
  • Community Mental Health Services / trends*
  • Early Medical Intervention / methods
  • Early Medical Intervention / statistics & numerical data*
  • Early Medical Intervention / trends*
  • Female
  • Hospitalization / statistics & numerical data
  • Hospitalization / trends*
  • Humans
  • Male
  • Outcome and Process Assessment, Health Care / statistics & numerical data*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Care Team / statistics & numerical data
  • Patient Care Team / trends*
  • Psychotic Disorders / therapy*
  • Quality of Life
  • United Kingdom