Innovative service resulting in fewer hospital admissions, writes CARL O'BRIEN
AN EARLY intervention service for mental health problems such as psychosis is resulting in faster recovery times and fewer admissions into hospital.
The Detect service, which is funded by the HSE and the Hospitaller Order of St John of God, has been operating in south Dublin and parts of Wicklow for the past five years.
Schizophrenia and other psychoses affect more than 120,000 people in Ireland. They carry a heavy burden for individuals, their families as well as a major economic cost to the State.
Figures released by the service show it has resulted in faster assessments, speedier treatment for conditions such as schizophrenia and improved long-term outcomes.
In all, about a third of clients were successfully treated in the community without resorting to in-patient care.
Follow-up studies show that a year following treatment, about 60 per cent of clients were back working and meeting friends on a regular basis.
This reflects international research which shows better outcomes associated with earlier treatment and care that is tailored for the early phase of a psychotic condition.
Detect, or the Dublin and East Treatment and Early Care Team, links in with three community mental health services in the south Dublin and Wicklow areas.
Its early intervention model consists of three basic components: a psychosis education campaign; a rapid assessment service; and specialised evidence-based treatment.
Of the 782 cases referred to the service between 2006 and 2010, a total of 351 met the criteria for psychotic conditions.
Of these, 41 per cent had schizophrenia, and smaller numbers were bi-polar (12 per cent), had a depressive episode with bi-polar symptoms (12 per cent) or had substance-induced psychosis (10 per cent).
The remaining 25 per cent met criteria for one of the rarer psychotic conditions, such as delusional disorder.
Dr Mary Clarke, a consultant psychiatric and clinical lead for the service, said while services could do little to prevent psychosis from happening, it was possible to reduce many of the disabilities and costs associated with psychosis.
“If the illness is recognised and treated at an earlier stage, people will achieve a better level of recovery,” she said.
The main types of evidence-based treatment the service provides are cognitive behavioural therapy, family education and support, and occupational therapy.
Research, both in Ireland and worldwide, has shown that many individuals with psychosis tend to experience long delays of between one and two years before receiving effective treatment, with resultant poorer outcomes.
Staff at Detect say that reducing this treatment delay has been crucial to good treatment outcomes in recent years.
A cost-effectiveness evaluation of the service is due to begin in April of this year, as well as a follow-up with research of clients who attended the service several years ago.
Mental health campaigners say the positive outcomes for patients indicate the model may have potential to be expanded on a national basis, given the priority in the State’s mental health blueprint – A Vision for Change – for early intervention and recovery-based treatment.