11. Intensive Home Treatment for First Episode Psychosis

This study paints a gloomier picture regarding opportunities to avoid admission. The study is prospective-unlike the previous two. Consequently, all early psychosis patients were assessed for home treatment. In the previous two studies, it is clearly implied in the Australian study that all prospective patients were seen; in the Hertfordshire study it was not clear. The setting of this study was one of high social deprivation and ethnic diversity-an inner city area-” a national  outlier” demographically. This would contribute to the smaller success in avoiding admisssion; the previous studies underlined the importance of social support -which presumably was relatively lacking here. Duration of untreated psychosis was likely long too.The results were that of the 111 patients, 54% were admitted immediately-a figure which rose to 72% after 3 months. The home treatment team took on almost a third of patients initially, but almost half of these had been admitted at 3 months. In total therefore only 18 of the 111 ( 16%) avoided admission altogether. From my experience, even if the patients end up admitted, their entry into the hospital can sometimes be smoother and less traumatic than if they had gone straight in ” off the street”, because of the involvement initially with the team and the relationships built up. Teams sometimes can follow the patients in hospital alongside hospital staff and may be able to shorten the stay, by accepting them back while still sub-acute. Initial treatment phase in early psychosis , can intensive home treatment prevent admission