A ten year study of intensive case management for young people at ultra high risk of developing psychosis has found that the model of care dramatically improved outcomes.
The research, which was devised and conducted at Orygen as a response to an increase in suicides amongst young people with first episode psychosis, showed that over the decade there were no suicides in the treated group and no instances of violence toward treating staff.
Intensive case management is a core component of the Early Psychosis Prevention and Intervention Centre (EPPIC) model, a service for people aged 15-24 with first episode psychosis developed at Orygen and now being rolled out nationally through headspace centres.
Following an increase in suicides of young people with first episode psychosis in the early 2000s, neuropsychologist and Honorary Fellow at Orygen, Associate Professor Warrick Brewer and colleagues devised, constructed and implemented a specialised pilot model of intensive case management to engage and manage these young people. The treated group was largely comprised of aggressive young men with family history of mental illness and violence and recognised as being both difficult to engage and at high risk of suicide.
The results of this study, which have been published by The Lancet Psychiatry show that after ten years, among those that took part in the intensive case management model of care, there were no suicides and violence to others was greatly reduced. Associate Professor Brewer believes the results will have wide ranging impact for the treatment of psychosis.
‘We demonstrated that we could treat this difficult to engage group, keep them out of hospital and reduce crisis contacts significantly. Our model of treatment provided a common sense means of validating extreme levels of anger that were underlying much of the distress of first episode psychosis and external signs of aggression.’
‘We have formulated a treatment manual that is accepted for publication to assist other clinicians to manage this difficult group.’
Professor Patrick McGorry AO, Executive Director of Orygen and co-author of the publication believes the result validates the central role of intensive case management in the national rollout of EPPIC services through headspace.
‘The fact over a decade this treatment was able to prevent all suicides and violence toward clinicians in a group that was previously at high risk of suicide is a great endorsement of how effective this treatment is. It shows that if young people are able to access best practice treatment early in the course of illness we can dramatically improve their chances of recovery. The rollout of this service across Australia is a crucial step toward making this care accessible to more young people.’
Read the abstract at The Lancet Psychiatry