Early Intervention in Psychosis - part two
The great thing about our service and all early intervention in psychosis teams is that we have an open referral system. what this means is that we can take referrals from anyone and anywhere; GP's, schools and colleges, mental health teams, youth clubs, schools, parents and families, young people themselves, their friends,drug and alcohol agencies, school nurses, health visitors, youth offending teams, voluntary agencies such as teams who work with homeless people and the socially excluded, prison in-reach teams and Connections etc....... anywhere! what this means is that hopefully we can pick people up earlier as soon as people become concerned that somethings not quite right. Traditionally in mental health teams the referrals have come through the GP's but this relies on the GP's knowing what they are looking for and it can also slow down the journey from someone asking for help to them getting it and being set in the direction of the most appropriate service.
what this means is that every once in a while we have to contact all these different teams and people and remind them we are here and what we do. it sounds simple but it is very time consuming and as psychosis is not easy to spot in the early stages, it can be mixed up with moody adolescence - withdrawing from social activities, up and down emotionally, tired or extreme energy, depression and anxiety, feeling suspicious there is often diagnostic confusion and debate about who we take i.e drug induced psychosis, peurepal psychosis, personality disorder with pseudo psychotic phenomena causes debate in our own team let alone with others
we go into schools and colleges and do presentations to staff and students about psychosis, what it looks like, the different types, the stress vulnerability model, the possibility of recovery and how common it is (3% of people experience a psychotic episode in their lifetime (World Health Organization) ) and the problem of stigma which can prevent people seeking help as well as socially excluding people. our talks are normally gratefully received, the students like having something different to do than lessons and the teachers seem to like getting advice on something most of them feel a little frightened off. we always hand out evaluation forms at the end so we know what they did and did not like or find useful and what we can change for next time, from the information we are gathering we hope to write a journal article about the psycho-education of young people. this is important as the World Health Organization have something called The Newcastle Declaration which has five statements these are:
1. raise community awareness
2.improve access and engagement
3.engage and support community workers
4.promote recovery and ordinary lives
5. teach practitioners and community workers
and by doing our presentation and teaching sessions in schools and colleges we aim to meet these standards and hopefully with the evaluation forms we can document whether the way we are doing it is successful. we will also hopefully see a rise in referrals or requests for information from the places we have been to. since we have started our publicity drive we have seen a rise in referrals from outside our mental health team colleagues which is good. it just seems to be a never ending job as teams change so often and people forget we are around unless they have regular contact. it does feel slightly strange however actively tracking down our service users rather than waiting them to come to us.