1 Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
2 Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Quebec, Canada.
3 ACCESS Open Minds (Pan-Canadian youth mental health services research network), Douglas Mental Health University Institute, Montreal, Quebec, Canada.
4 Douglas Mental Health University Institute, Montreal, Quebec, Canada.
5 Concordia University, Montreal, Quebec, Canada.

Description, evaluation and scale-up potential of a model for rapid access to early intervention for psychosis.

Early Interv Psychiatry. 2018 12;12(6):1222-1228

Authors: MacDonald K, Malla A, Joober R, Shah JL, Goldberg K, Abadi S, Doyle M, Iyer SN

Abstract

AIM: This paper aims to describe the entry protocol of the Prevention and Early Intervention for Psychosis Program (PEPP)-Montreal, an early intervention program for psychosis. The protocol is designed to fulfil a key objective of the early intervention movement-reducing delays to accessing high-quality care. The paper also aims to describe how this rapid entry protocol can be deployed in other services interested in reducing delays in initiating treatment.

METHODS: PEPP provides rapid, easy access to quality care by placing a single, well-trained professional, the intake clinician, at the point of entry. Anyone can refer a youth directly and without formalities to the intake clinician who responds promptly and sensitively to all help-seeking, whether by a youth, a family member, a school counsellor or anyone acting on behalf of a youth in need. To promote accessibility, PEPP guarantees an initial assessment within 72?hours; maintains relationships with referral sources; and conducts awareness-enhancing outreach activities.

RESULTS: Since 2003, PEPP has received 1750 referrals, which have all been responded to within 72?hours. Families have been involved in the intake process in 60% of the cases and hospitalization may have been averted in over half of the referrals originating from emergency-room services. Another indicator of success is the very low turnover in the intake clinician's position. Overall, the PEPP model has succeeded in providing rapid, engaging, easy and youth-friendly access to high-quality care.

CONCLUSION: The success of this protocol at PEPP has inspired the entry protocols at other first-episode psychosis services. Its ability to provide rapid, engaging access to high-quality services may allow this protocol to become a model for other early intervention services for psychosis and other mental illnesses.

PMID: 29582562 [PubMed - indexed for MEDLINE]