Article

Evolution of early psychosis intervention services in Singapore

Department of Early Psychosis Intervention, Institute of Mental Health, Singapore.
East Asian archives of psychiatry : official journal of the Hong Kong College of Psychiatrists = Dong Ya jing shen ke xue zhi : Xianggang jing shen ke yi xue yuan qi kan 09/2012; 22(3):114-7.
Source: PubMed

ABSTRACT The alarmingly long duration of untreated psychosis in Singapore and probable severe consequences were the impetus for establishing the Early Psychosis Intervention Programme in 2001. In 2007, the Early Psychosis Intervention Programme became a part of the National Mental Health Blueprint. This study analysed the Early Psychosis Intervention Programme's key outcomes according to the case management model, and shows how the programme has evolved and expanded into indicated prevention by establishment of the Support for Wellness Achievement Programme focusing on at-risk mental state. The Early Psychosis Intervention Programme has incorporated an evaluation component into the clinical programme by administering regular structured assessments and generating operational statistics from the hospital's data systems. Based on data analysis from a study on consecutive patients accepted into the Early Psychosis Intervention Programme over a 4-year period, we found that at the end of 2 years of follow-up, majority of patients (85%) scored ≥ 61 on Global Assessment of Functioning (GAF) disability scale, while two-thirds (66%) met criteria for functional remission, which was defined as having a GAF disability score of ≥ 61 with engagement in age-appropriate vocation (gainfully employed or studying). There was also a significant decrease in the Positive and Negative Syndrome Scale for schizophrenia (t = 27.7, p < 0.05) and increase in GAF (t = 33.7, p < 0.05) mean scores from baseline at 2 years. As a national programme, the Early Psychosis Intervention Programme has articulated processes and outcome indicators to the stakeholders, and a periodic report card on these outcomes ensures accountability to the funders, patients, and their families.

1 Follower
 · 
94 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To describe the development and validation of the criteria used at the Personal Assessment and Crisis Evaluation (PACE) Clinic to identify young people at ‘ultra-high’ risk of developing a psychotic disorder within a short follow-up period.Method: The PACE Clinic criteria initially grew out of clinical observations and retrospective research describing the prodromal phase of first-episode psychosis. Early prospective research refined the criteria into the three intake groups for the Clinic. These criteria combine putative state and trait risk factors for psychosis. Whether or not a person meets criteria for one or more of these groups can usually be determined by a thorough psychological assessment interview. Two early studies are described that assess the validity of this screening protocol.Results: The transition rate to acute psychosis of the ‘ultra-high’ risk group identified in the second study was 41%.Conclusions: These results suggest that it is possible to accurately identify young people at imminent risk of psychosis. The PACE criteria have now been adopted (or adapted) by a number of other clinical research programs both in Australia (i.e. Psychological Assistance Service in Newcastle) and other programs in the United States and elsewhere. This research may lead the way to the development of preventive interventions for the ultra-high risk group.
    Australian and New Zealand Journal of Psychiatry 10/2000; 34(s2):S164 - S169. DOI:10.1046/j.1440-1614.2000.00798.x · 3.77 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: International declarations that articulate core values, goals and standards have played an important role in enhancing the quality of care in a number of areas of medicine. This document attempts this task for early intervention in psychotic disorders. It was originally inspired by the St Vincents declaration on the care of diabetes and carefully developed by David Shiers and Jo Smith with support from the Initiative to Reduce the Impact of Schizophrenia, National Institute for Mental Health in England and Rethink, resulting in the UK-focused Newcastle Declaration. The World Health Organization and the International Early Psychosis Association then collaborated to produce an international version of the declaration, which articulates the universal principles of early intervention and tries to blend these with local capacities and cultural diversity.
    The British journal of psychiatry. Supplement 09/2005; 48(48):s116-9. DOI:10.1192/bjp.187.48.s116

Preview

Download
4 Downloads
Available from