Alan Rosen1,2; 1Brain & Mind Centre, University of Sydney, Australia, 2Illawarra Institute of Mental Health, University of Wollongong, Australia
Does the evidence support having Early Intervention (EI) teams which cover wider diagnoses and age groups, or at this stage does it still only squarely supports having discrete teams for early intervention teams for young people with first episodes of psychosis? Meanwhile, triage and initial counselling services as a "one-stop-shop" or "clearing house" for assessing and assisting with all mental health disorders in young people, or exploratory programs for EI's of other disorders and other age-groups may be promising. However, they require further evaluation at this stage, for evidence of better outcomes. At the same time, perhaps we should consider EIP teams for young people reserving a minority of places (say 10-20%) for severe high intensity disorders of a wider spectrum of psychiatric diagnoses which require a similar approach (as for psychosis) whether in ultra high risk states, acute early episodes requiring intensive mobile community care and assertive rehabilitative/recovery work. eg post-traumatic, major affective disorders, disabling anxiety states, and severe eating disorders.This would not denature the clinical and functional teamwork protocols and therefore should result in equivalent outcomes as for first episode psychoses. Training, working and supervising to evolving fidelity criteria for evidence based early interventions and service delivery systems, as well as contextual considerations, like agegroup specific and friendly facilities and practices, and home visits and social system intervention to engage, educate and elicit collaboration with both individuals and families, may be more crucial to success than procedural purity.
