1. First Episode Psychosis: National Standards awareness for Primary Care
Autumn 2017

2. Background to National Standards
Five year forward view: by 2020 we want those experiencing FEP to start treatment within a fortnight
Government’s mandate to NHSE “deliverable” & NHS planning guidance 2016/17 – 2020/21 “national must do” : more than 50 percent of people experiencing a first episode of psychosis will commence treatment with a NICE approved care package within two weeks of referral

3. Why intervene early in FEP?
Disability from psychosis plateaus by 3 years – providing major opportunities for effective early intervention: preventing secondary sequalae and substantially lowering mortality and morbidity
Outcome at 3 years predicts outcome at 15 years
Suicide risk highest <5yrs of onset
Reduced Duration of Untreated Psychosis (DUP) robustly linked to good outcome

4. Why intervene early in FEP?
Economic evaluation of early intervention (EI) services: cost effective (2010, McCrone et al.)
EI = effective model to help people recover from FEP and gain a good quality of life (2011, No health without mental health)
2014 Rethink mental illness: Lost Generation:

5. National EIP standards

6. NICE concordant package for FEP

7. Early Intervention is everybody’s business
EIP services need to work alongside primary care services
GPs offer continuity, context and family practice
GPs have a key role in care pathway of emerging psychosis
GPs listen and act on concerns of the family
Physical health care of those with psychosis and on antipsychotic treatment must be robust

8. https://vimeo.com/bigpicturecharityfilms/review/222205508/658be0247a
Early Intervention in Psychosis: minute film for GPs Endorsed by the RCGP

9. Physical Health in Psychosis
Life expectancy reduced by years
75% deaths attributable to physical causes
Cardiovascular disease = main culprit
Primary care plays key role in physical health monitoring and intervention
Don’t just screen – intervene!
Lester tool here

10. Your Local EIP Service Name of EIP Team Address of EIP team
Clinical Team Leader……
Dedicated 3 year EI service for year olds with FEP
Access via single point of contact……………….
Flag referral as “suspected first episode of psychosis”
Also see IRIS website for a list of regional EIP services

11. First episode psychosis is treatable; recovery is expected
Affects all ages, although more common in young adults
Onset often gradual with decline in functioning
Substances often used to ‘self-medicate’ for distress
Ask about unusual experiences and risk
Local EIP services aim to see referrals within 2 weeks
Physical health monitoring essential for those taking antipsychotics

12. Your Local EIP Service Name of EIP Team Address of EIP team
Clinical Team Leader……
Dedicated 3 year EI service for year olds with FEP
Access via single point of contact……………….
Flag referral as “suspected first episode of psychosis”
Also see IRIS website for a list of regional EIP services