IEPA 11

Patrick McGorry1,2; 1Orygen Youth Mental Health Centre, University of Melbourne, Australia, 2International Association for Youth Mental Health, Australia
           
Dementia Praecox was named thus for a reason. Most cases appear in young people though a minority of cases do present later in life, some after youth onsets with very long DUPs.  The AESOP study data, which seems to have prompted the unfortunate move of inducing early intervention services in some countries to fall for the “3 card trick” of adding in older patients without more resources. Instead of creating a developmentally appropriate model for this subgroup, the successful and cost effective EI model has been undermined in a reversion to the status quo.  Much more sensible would have been adding resources and making the EI model available to a range of complex syndromes where working intensively to EI protocols and specialist expertise are required.  This would build a specialist youth mental health model to integrate horizontally with EIP services and vertically with youth friendly primary care and also with acute youth mental health care including inpatient services.  While over-relying on the AESOP study which is out of kilter with most of the literature, and possibly over-estimating the proportion of disabling FEP’s emerging in older age groups, Lappin et al (2016) legitimately argue for EI provision for FEP’s starting over 25 or even 35.  They also suffer from delayed access and outcomes that are equally as poor as in younger individuals with FEP, which are likely to be improved by more intensive and sustained EIP care. The question is how to do it, without disrupting clearly evidence-based EIP youth-friendly services.