Using a dedicated pathway for patients with an ultra-high risk of psychosis at a London CAMHS community unit led to fewer admissions, quicker psychiatric review and a shorter wait for treatment.
Rebecca Adams at the Tower Hamlets CAMHS unit of the East London NHS Foundation Trust and colleagues assessed 41 cases over 2 years: 16 followed a standard pathway with no provision for early detection and 26 patients followed the psychosis pathway.
Transition rate from ultra-high risk to psychotic illness was 56% in 2 years for those following the pathway, compared to 75% before the pathway was used.
The psychosis pathway included additional staff training, rapid and regular clinical monitoring, targeted CBT and psychoeducation to try to minimise relapse and the long-term impact of psychosis.
Although this service evaluation can only make limited comparisons between a historical pathway which did not define individuals at high risk with a targeted one that does identify high risk presentations, it seems to support further long-term studies into this targeted approach.
Ulhaq, S., Thevan, K. and Adams, R. (2017), Innovations in Practice: Identifying young people at ultra-high risk of psychosis in a Child and Adolescent Mental Health Service. Child Adolesc Ment Health, 22: 91–95. doi:10.1111/camh.12173
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