Early intervention is key to reform of mental health services - Hamish Kidd

With the Scottish Parliament now in its pre-election period, reform of mental health services is firmly on the agenda. Early intervention is being advocated as both a general principle and, in the context of psychosis, a specific model for delivering care and support.
Hamish Kidd, Engagement Project Worker, Support in Mind ScotlandHamish Kidd, Engagement Project Worker, Support in Mind Scotland
Hamish Kidd, Engagement Project Worker, Support in Mind Scotland

The coronavirus pandemic has highlighted the demand for mental health support that is available to all quickly, to pre-empt crisis, and for NHS boards across Scotland to develop Early Intervention services for people experiencing first-episode psychosis.

National mental health charity Support in Mind Scotland was invited to be part of the Scottish Government’s Early Intervention in Psychosis short life working group.

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A key part of our work is to inform the policies that impact on the rights of the individuals and families we support through the delivery of our services. To help with that process we have just published a report that compiles the findings of engagement work, commissioned by Healthcare Improvement Scotland.

This important project gathered views from more than 130 people across Scotland, with lived experience of psychosis.

We talked to people who had accessed services for psychosis and the family members, or friends who had supported them.

They told us that existing mental health services were difficult to access, even at the point of crisis. Initial delays had far-reaching consequences. Many had to rely on emergency services to enable them to access mental health services at all.

As a result they arrived more unwell, and were more likely to require hospital admission. Access to psychological therapies were rare, and issues around overuse of medication were common. There were concerns about human rights considerations for both individuals and their families.

People with lived experience are calling for four domains of change, namely:

◦ Public awareness of psychosis needs to be raised and the associated stigma addressed.

◦ People who experience first episode psychosis need person-centred care delivered by a well-coordinated partnership of statutory and third sector organisations.

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◦ Family members, partners and supporters of people with first-episode psychosis need to be identified quickly and worked with pro-actively by services.

◦ A human rights-based approach should be at the heart of the design, implementation and delivery of services for people who experience first-episode psychosis.

The findings accompanied research by Healthcare Improvement Scotland which found significant variation in the provision of care and treatment for people with first episode psychosis across Scotland.

In wider societal terms, evidence shows providing Early Intervention in Psychosis (EIP) services leads to longer term cost savings to the NHS and wider society. At present only one EIP service exists in Scotland: Esteem in NHS Greater Glasgow & Clyde.

This collaborative approach has yielded some consensus about what the next steps need to be in order to improve outcomes for individuals and their families.

The Minister for Mental Health, Clare Haughey MSP, has received both reports prior to the election recess. The response from the Scottish Government is anticipated to follow the Scottish Parliament election on May 6.

For support in a crisis, the Samaritans helpline is 116 123 and is open 24 hours, 7 days a week. Online support is also available 24/7 on the Clic platform, provided by Mental Health UK, at https://clic-uk.org/

Hamish Kidd, Engagement Project Worker, Support in Mind Scotland

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