Early Intervention in Psychosis

Client challenge

The UK’s first ever waiting time standards for access to NHS mental health services brought mental healthcare into line with physical health, with the ambitious target that people with a suspected first episode of psychotic illness should be assessed and 50 per cent referred for treatment within two weeks.

This reflects a growing understanding that early intervention can make an enormous difference for psychosis. Getting this right promises to transform lives, free up capacity in trusts – and save the NHS scarce resources.

  • Psychiatrists, nurses and other professionals in London’s 28 Early Intervention team work differently across nine mental health trusts and there are a variety of referral routes. The digital campaign had to reach busy clinical staff, many of whom work on a ward with limited access to IT.
  • There were skills gaps, for example insufficient staff qualified in specialist therapies required a rapid training programme in each service, and London-wide
  • Rapid assessment relies on people seeking help. This means friends, family and communities spotting symptoms and behaviours, or those in professional roles outside of mental healthcare, such as social workers, teachers or police officers.
  • General practitioners are key – they are the ‘first port of call’ for many seeking help, and in most places required to make the referral for assessment. The digital campaign had to raise awareness and provide differentiated information to more than 8,000 family doctors in 1,700 practices.

Our solution

But how well prepared were Londoners to meet this challenge?

We commissioned a ground-breaking survey into public attitudes to psychosis, to understand the level of public awareness and knowledge about psychosis, the kinds of behaviours which would prompt people to seek help – and where Londoners might turn.

We developed the idea of a ‘psychosis-aware London’ as the organising principle to drive the digital campaign, encompassing mental health staff, GPs and other professionals – alongside local organisations, communities, friends and families.

A digital campaign was developed to reach front-line staff in hospitals with credibility and cut-through, with a bespoke website to provide information and support for professionals and public alike.

It contains a wealth of resources section is key, with strong use of videos, including an animation featuring an avatar of Simon Clarke, head of one of the London services. It has an upbeat design and materials to inform, reassure, and inspire. The navigation routes visitors quickly to the right content for them, and linked to materials for download and print.

A particular need identified was to support GPs to identify and refer for assessment, and Health Education England funded a discrete set element of the programme, with bespoke website content linked to training and development opportunities organised by individual CCGs for their members.

There are also materials for professionals from other sectors, such as those working with young people – as well as information designed for the public. This includes materials for youth groups, education and social media sharing.

Materials were developed and delivered with and through professional networks, for example GP materials were available online to support locally-led training initiatives in an integrated campaign.  In delivering this project, we developed a whole approach to reaching 8,000 family doctors in 1,700 practices, who refer patients to 32 different local hospital sites.

The outcome

As at April 2016, London was rated among the best regions in the country in terms of readiness to implement the new standard.

A key success factor was working effectively across many organisations with multiple stakeholders, and complex clinical and leadership structures.

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