PSYCHOSIS : HEALTH CARE EXIGENCY AND REQUIRE POLICYMAKING

Psychosis is a medical term used to describe hearing or seeing things that are not there, or holding delusional beliefs. Common examples include hearing voices or believing that people are trying to do you harm. It can be experienced as a one-off episode, but if left untreated can lead to long term illness and disability.

Early Intervention in Psychosis(EIP) can significantly improves a young person’s prospects of recovering from psychosis. It also reduces the likelihood that they will relapse or be detained under the mental health, potentially saving the medical health cost each year through reduced use of hospital beds. Early intervention also reduces the risk of a young person taking their own life from upto15% to 1%. Many young people are facing unacceptable delays in accessing Early Intervention in Psychosis(EIP) care. This seriously affects their chances of recovery and increases the likelihood of them developing a life long illness. As a result, we are at risk of losing a generation of young people whose recovery from mental illness is being jeopardized–tens of thousands of young people who with the right support might otherwise have good quality of life and play a meaningful role in society. 

Around 1 in 100 people will develop a full psychotic episode in their life time. The vast majority(8 out of 10) will experience their first episode between the ages of 15 and 30. Psychosis can have an extremely damaging impact on a young person’s well being and quality of life. It can affect their relationships with friends and family and their ability to engage in  education, training and employment. It also makes it very difficult to manage everyday tasks, like paying bills or rent. This leaves young people vulnerable to developing a serious mental health crisis or being detained in hospital under the Mental Health.

Early intervention makes a massive difference in helping young people recover from a first episode of psychosis. When someone receives Early Intervention support within two months, their prospects of recovery are significantly improved but a delay of longer than six months greatly reduces their chances. Similarly, when a young person receives Early Intervention support in the first 14 months of their illness, they are much more likely to make a full long term recovery. Interventions are most effective when provided by a specialist team. They often include family therapy, support with maintaining employment and education, advice on managing physical healthcare and help with developing support networks with family and friends. People must receive EIP care normally for a minimum of three years and a maximum of five years.

Young people being treated for psychosis are vulnerable to developing side effects from antipsychotic medication, including rapid weight gain and changes to metabolism. Overtime, these can lead to conditions like diabetes, heart disease and cancer, which puts young people at significant risk of dying 15-20 years younger than the general population. EIP teams offer young people support with managing their physical health or other mental health services. This is recognised in the international Healthy Active Lives(HeAL) consensus statement.

Reducing demand on other services people who have EIP support are less likely to need other mental health services such as expensive hospital care which results in significant savings for the National Health Service (NHS). It also reduces the probability of someone being detained in hospital under the Mental Health from 44% to 23% in the first two months of psychosis. By reducing dependence on hospital beds, EIP can saves the National Health Service(NHS) an estimated medical expenses per person in the first year of psychosis and during the first three years if early intervention was available to everyone who could benefit from it.

Young people using EIP can be able to provide more positive experiences of care than of other mental health services. EIP support will help young people to gain a positive sense of self-identity and develop strong family relationships which in turn means family members are more engaged in the care that a young person receives. They also welcomed the flexibility of EIP support, especially in relation to the length of time that it is available to them.

But this is far from a reality for people with psychosis. Many people miss out on crucial treatments recommended by the National Institute for Health and Care. As a result, people with psychosis often face appalling health problems and poor quality of life. Such as •People with psychosis and other severe mental illnesses die on average15-20 years younger than the general population mainly from preventable physical health problems.

•There are no mandatory waiting times for access to specialist mental health services as there are in physical health care.                     

•Fewer than 30% of people with schizophrenia receive recommended physical health checks.

•Only 8% of people with psychosis and schizophrenia are in employment. 

•Fewer than 50% of people with schizophrenia are offered recommended talking therapies.

In the context of these health inequalities, the value of the holistic support will get offered by EIP. The EIP support will offer in terms of physical health, talking therapies and employment which are rarely available to young people with psychosis. Due to this EIP will become as one of the most effective models for supporting people with psychosis. The holistic ethos of EIP services should under pin all mental health services for people affected by psychosis. EIP services should be viewed by local and national decision-makers as a solution to some of the problems caused by inequalities in the NHS and an important step towards achieving ‘parity of esteem’.

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