Intervening early in psychosis can make all the difference argues Brian Dow, Deputy CEO at Rethink Mental Illness. But how common is psychosis and what support is available if and when you seek it out?

“It started small, like hearing my name in a crowd, and then gradually I’d hear voices repeating every negative thought I’d ever had about myself.” Luke, 26, first started experiencing signs of psychosis at school. In a new film launched today by the charity Rethink Mental Illness, Luke and his dad (both pictured, above) discuss those early days of his illness and what going through an episode of psychosis is like.

"Less than a third of the public say they would know where to get help if they or someone they knew were showing signs of psychosis."

Thankfully, Luke got the help he needed and is now doing well. He is one of thousands to have benefited from Early Intervention in Psychosis (EIP), which is a package of care offered by the NHS. Its aim is to help young people aged 14 to 35 to recover from a first episode of psychosis, and to gain a good quality of life.

EIP is a holistic approach. It includes offering support from a wide range of health professionals, including psychiatrists, psychologists, community mental health nurses, social workers and support workers. Part of this package can include Cognitive Behavioural Therapy (CBT), but also access to support groups. In Luke’s case, he was told about a group in his area where young people met to talk to one another about their experience of psychosis. Luke recalls being reluctant to go, but when he did found it hugely helpful to meet others who were in a similar boat.

  • Early Intervention in Psychosis (EIP) support waiting times standards and accompanying funding were rolled out nationally in 2016 as one of the core pledges in the Five Year Forward View for Mental Health in 2016.
  • Self-referring sometimes takes place, but referrals are usually made via a GP or A&E.
  • 74% of people access treatment within two weeks of seeking help. There are big variations across the country through, from 5% in some areas through to 100% in areas with better provision.

Mystique

In a recent survey Rethink Mental Illness did among the general population, we found that psychosis was still something shrouded in mystery for a lot of people. Results are released today (September 18). Among young people, the age at which you’re most likely to have your first episode, figures showed that only a third (31%) would know where to get help if they or someone they knew were showing signs of psychosis.

Over half (56%) thought psychosis was less common than it is. Fewer than half said they were not confident they would be able to spot specific symptoms like hallucinations (47%) and delusions (42%). Early signs can also be more subtle and include things like withdrawing from friends and family or sudden changes in mood.

There is a wealth of evidence which shows early intervention significantly improves people’s prospects of recovery and reduces the likelihood of them relapsing or taking their own life. There are also economical benefits: people who have EIP support are less likely to need other mental health services down the line, such as expensive hospital care, which results in savings for the NHS. It also reduces the probability of someone being detained in hospital under the Mental Health Act from 44% to 23% in the first two months of psychosis.

Physical health support

Young people being treated for psychosis are also vulnerable to developing side effects from antipsychotic medication, including rapid weight gain and changes to metabolism. Over time, these can lead to conditions like diabetes, heart disease and cancer, which puts young people at significant risk of dying 15 to 20 years younger than the general population. EIP teams offer young people support with managing their physical health which is rarely available to them from their GP or other mental health services.

EIP is not a luxury service. Tens of thousands of young people rely on it to get the support they need to recover and gain a good quality of life. To access support, it helps to be aware of the early signs and symptoms, so people know to seek help as soon as possible. But also, with more awareness the hope is that people having those early symptoms will have more confidence that there is help available and recovery is possible.

Watch Rethink Mental Illness’ news film here: https://www.rethink.org/rethinkschizophrenia

(currently there is a trailer here but from 11am on 18 September the whole three minute film will be live.)

Brian Dow is deputy CEO at Rethink Mental Illness.