First episode psychosis services have been shown to be effective in several large randomized controlled studies in different health care systems. There is a growing consensus as to the essential components of such services and fidelity scales have been developed to assess the degree to which services deliver the essential evidence based components. Fidelity scales can be used for assessing implementation of new programs, ensuring quality of existing programs and by funders for setting standards. The international health challenge is now to broaden access to first episode psychosis services and to ensure that existing services continue to deliver evidence based care. Fidelity scales are one of the tools that can be used to support access to quality services, but their application is challenging. Several fidelity scales are now available, and are being applied in the United States, Italy, Canada, Denmark, and Australia. In this symposium we will examine the challenges of large scale application of fidelity scales. Speakers will illustrate how these challenges are being overcome and fidelity scales are being applied in the United States, Canada, Australia, and Denmark. Mental health services have been slower to measure access and quality of services than other health services. Developing the systems required to support evidence based quality assessment for first episode psychosis services can lead to broader application in other aspects of mental health services.
