Tracking the 3-year trajectory of referrals to an early psychosis intervention service

TL;DR

This study examines the referral patterns and outcomes of patients to an early psychosis intervention service in New Zealand over four years.

Contribution

The study identifies factors influencing acceptance or decline of referrals and highlights the need for clear entry criteria in early psychosis services.

Findings

About half of referrals were accepted, while 38% were declined, often due to long duration of psychosis or no evidence of psychosis.

No significant differences were found in emergency department visits or psychiatric admissions between accepted and declined groups.

The study suggests the need for improved screening processes and collaboration among early psychosis intervention services.

Abstract

To review the baseline and clinical characteristics of patients referred to a New Zealand Early Psychosis Intervention (EPI) service across a 4-year timeframe.

We compared two cohorts, and identified variables associated with being accepted or declined, and reasons for decline, by an EPI service between 2013 and 2017.

There were 576 people with suspected psychosis referred to the EPI service for assessment: 300 (52%) were accepted, 221 (38%) declined and 55 (10%) were not processed. Reasons for being declined by EPI services were a long duration of psychosis (DUP, 48%) and no evidence of psychosis (47%). There were no significant differences between the accepted and declined group in Emergency Department presentations for self-harm or suicide attempts and acute admissions to a psychiatric inpatient unit over the 3-year follow-up period.

To optimise the identification of true positive cases, EPI services require clear entry criteria. Replicating this study in other EPI services with different entry criteria may provide evidence to develop a more uniform screening process. Improved outcomes may be enhanced by measuring effectiveness and liaising with other EPI services.

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