The emerging pattern of sub-teams are currently: Multidisciplinary clinical teams providing an intensive case management approach for the first three to five years.
For example, the use of low-dose antipsychotic medication is promoted ("start low, go slow"), with a need for monitoring of side effects and an intensive and deliberate period of psycho-education for patients and families that are new to the mental health system.
[11] Interventions to prevent a further episodes of psychosis (a "relapse") and strategies that encourage a return to normal vocation and social activity are a priority.
[14] Teams provide information and education to the general public and assist GPs with recognition and response to those with suspected signs, for example: EPPIC's[15] Youth Access Team (YAT)[16] (Melbourne); OPUS[17] (Denmark); TIPS[18] (Norway); REDIRECT[19] (Birmingham); LEO CAT (London)[20] "; STEP's Population Health approach to early detection.
[34] In 2015, the European Psychiatric Association issued guidance recommending the use of the Cognitive Disturbances scale (COGDIS), a subscale of the basic symptoms scale, to assess psychosis risk; a meta-analysis conducted for the guidance found that while rates of conversion to psychosis were similar to those who meet Ultra High Risk (UHR) criteria up to 2 years after assessment, they were significantly higher after 2 years for those patients who met the COGDIS criteria.
Psychosis is now formulated within a diathesis–stress model, allowing a more hopeful view of prognosis, and expects full recovery for those with early emerging psychotic symptoms.
Within this changing view of psychosis and schizophrenia, the model has developed from a divergence of several different ideas, and from a number of sites, beginning with the closure of psychiatric institutions signaling a move toward community based care.
[45][46] A systematic review conducted in 2019 concluded that there is evidence to support this claim; however, many of the available studies on the cost-effectiveness of these services have methodological flaws, and it is unclear whether their results will translate to lower-income countries.
[47] Another review conducted in 2020 likewise found low-certainty evidence that early intervention reduces the risk of subsequent in-patient hospitalization.
The Mental Health Policy Implementation Guide outlines service specifications and forms the basis of a newly developed fidelity tool.
[51][52][53] On August 19, 2011, Patrick McGorry, South Australian Social Inclusion Commissioner David Cappo AO and Frank Quinlan, CEO of the Mental Health Council of Australia, addressed a meeting of the Council of Australian Governments (COAG), chaired by Prime Minister Julia Gillard, on the future direction of mental health policy and the need for priority funding for early intervention.
[58][59] Canada has extensive coverage across most provinces, including established clinical services and comprehensive academic research in British Columbia (Vancouver), Alberta (EPT in Calgary), Quebec (PEPP-Montreal), and Ontario (PEPP, FEPP).
[60] In the United States, the implementation of coordinated specialty care (CSC), as a recovery-oriented treatment program for people with first episode psychosis (FEP), has become a US health policy priority.
The goal is to link the individual with a CSC team as soon as possible after psychotic symptoms begin[62] because a longer period of unchecked and untreated illness might be associated with poorer outcomes.