Truth and reality in early intervention

@article{McGorry2012TruthAR,
  title={Truth and reality in early intervention},
  author={Patrick D. McGorry},
  journal={Australian \& New Zealand Journal of Psychiatry},
  year={2012},
  volume={46},
  pages={313 - 316}
}
  • P. McGorry
  • Published 1 April 2012
  • Medicine, Psychology
  • Australian & New Zealand Journal of Psychiatry
‘I have seen how much progress early intervention teams have made, how innovative they have been, and the impact they are having. I now believe that early intervention will be the most important and far-reaching reform of the National Service Framework era. Crisis resolution has had the most immediate effect but I think early intervention will have the greatest effect on people’s lives.’ Professor Louis Appleby (then) Director, National Institute of Mental Health in England, 10 October 2008 at… 

Discussion, debate and some areas for positive action

  • Anthony F Jorm
  • Psychology, Medicine
    The Australian and New Zealand journal of psychiatry
  • 2013
TLDR
There is a continuation of the discussion of the merits of early intervention, which has been a major focus of the Australian Government’s mental health reforms, and evidence for a number of programs that would provide practical benefits to psychiatric patients is presented.

Early Intervention in Psychosis

  • P. McGorry
  • Medicine, Psychology
    The Journal of nervous and mental disease
  • 2015
TLDR
The origins and rapid development of early intervention in psychosis are described from a personal and Australian perspective and this uniquely evidence-informed, evidence-building and cost-effective reform provides a blueprint and launch pad to radically change the wider landscape of mental health care and dissolve many of the barriers that have constrained progress for so long.

[Early intervention in psychosis: concepts, current knowledge and future directions].

TLDR
The status of the early intervention movement (in terms of availability and policy) in Western public healthcare systems can be resolved into a spectrum and the United Kingdom is shown to be the leader while Canada appears at the middle of the spectrum.

Transparency and accountability in early psychosis intervention research

TLDR
I would like to see the group go on to propose models for straddling this Cartesian divide, allowing the development of inclusive, non-stigmatising and readily disseminated services for young people with both medical and psychiatric needs.

Risk assessment for violence and self-harm in first episode psychosis and the need for early psychosis intervention services

TLDR
The potential for early intervention services to reduce the incidence of both violence and suicidal behaviour in first episode psychosis is considered and a notable finding was a lack of an association between positive symptoms and either violence or self-harm.

Ethics of giving antipsychotic medication to at-risk young people

  • A. Jorm
  • Psychology, Medicine
    The Australian and New Zealand journal of psychiatry
  • 2012
In his response to critics of early intervention for psychosis, Patrick McGorry (2012) makes some negative statements about those who have questioned the ethics of using antipsychotic medication with

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TLDR
It is argued that even in those OECD countries with a long history of deinstitutionalisation, there is still a long way to go to make community-based mental health care that achieves good outcomes for people with severe mental illness a reality.

Evidence-based mental health services reform in Australia: Where to next?

TLDR
In the ANZJP, there has been on-going discussion and debate about three reforms in particular: the Better Access scheme, the Healthy Kids Check and the roll-out of early psychosis services.

Treatment to reduce risk of psychosis: The need to consider the potential harms as well as the benefits

  • Anthony F Jorm
  • Psychology, Medicine
    The Australian and New Zealand journal of psychiatry
  • 2013
TLDR
Preventing a first episode of psychosis: Meta-analysis of randomized controlled prevention trials and a heuristic framework for choosing earlier, safer and more effective interventions.

Debates, disputes, discussions and deliberations

  • C. Galletly
  • Psychology, Medicine
    The Australian and New Zealand journal of psychiatry
  • 2012
TLDR
In this issue, MacLeod argues that psychiatrists should play a greater role in the assessment of patients requesting assistance with dying, and the need for more research to identify the best therapies for refugees and other survivors of mass conflicts is highlighted.

References

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At issue: Cochrane, early intervention, and mental health reform: analysis, paralysis, or evidence-informed progress?

  • P. McGorry
  • Medicine, Political Science
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  • 2012
TLDR
The evidence-based paradigm must not be misused to stifle or paralyze urgent reform, and there is a real risk that, if the sophistication of EBHC is not improved, the whole paradigm will be sidelined and reform will remain reactive, impulsive, and desultory.

The truth, and nothing but the truth, about early intervention in psychosis

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  • Psychology, Medicine
    The Australian and New Zealand journal of psychiatry
  • 2012
TLDR
This article, an extension of earlier critiques, asks whether early intervention should be such a major focus in mental health reform and poses a question about ‘caseness’.

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TLDR
Early intervention did not increase costs and was highly likely to be cost- effective when compared with standard care, and when costs were combined with improved vocational and quality of life outcomes it was shown that early intervention would have a very high likelihood of being cost-effective.

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TLDR
This model suggests that services that permit early detection of people at high risk of psychosis may be cost saving.

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TLDR
Early treatment had positive effects on clinical and functional status at 5-year follow-up in first episode psychosis and could be explained by confounders.

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TLDR
This survey confirmed existing knowledge on the social and service needs of this population, in finding high rates of unemployment and homelessness, poor engagement with services and frequent involuntary pathways to mental healthcare.

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TLDR
It is argued that pre-emptive psychosis-related diagnoses cannot be justified either, and that such diagnoses are also harmful in research, because of the consequences.

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TLDR
Outcomes for the participants treated by the early onset team were significantly better at 18 months for aspects of social and vocational functioning, satisfaction, quality of life and medication adherence, which provides support for current policy.