Early Intervention Teams

You might get help from an early intervention in psychosis (EIP) service if you have psychosis for the first time. This page explains how these services can help you.

Overview

  • Early intervention in psychosis (EIP) services work with you the first time you have psychosis. They may call this your ‘first episode’.
  • In some areas EIP services are for people under a certain age. Usually this is 35.
  • Psychosis means having unusual beliefs or experiencing things that other people do not, like hearing voices.
  • It is important to get help as soon as you have your first psychotic episode. Getting help straight away will give you a higher chance of getting better. EIP services should try to help you as soon as possible.
  • The service will have psychiatrists, psychologists, community psychiatric nurses, social workers and support workers.
  • Your GP can pass your details to your local EIP service. In some areas, you may be able to refer yourself. 

About Early Intervention services

Early intervention in psychosis (EIP) services can support you if you have ‘psychosis’ for the first time. Psychosis is a word doctors use if you see or hear things that aren’t real, or if you have unusual beliefs that are not true. It is common in people who have a diagnosis of schizophrenia, schizo-affective disorder and bipolar disorder. Cannabis and other drugs can sometimes cause psychosis, so you might get help from an EIP service if you have used drugs.

The National Institute for Health and Care Excellence (NICE) recommends that early intervention services should be open to people of all ages. However, some services only help people under a certain age – usually under 35.

Early Intervention teams

An Early intervention in psychosis (EIP) service will have staff from different backgrounds. Most staff will have health or social care backgrounds and include psychiatrists, social workers, nurses, and psychologists.

Care Coordinators
A care coordinator is the person who is responsible for organising and monitoring your care. Normally, you will see your care coordinator more often than other NHS staff. Care coordinators can be nurses, social workers, community psychiatric nurses (CPN) or occupational therapists.

Psychiatrists
A psychiatrist is a medical doctor who specialised in mental health. They can diagnose mental illness, prescribe medication and recommend treatment.

Social workers
A social worker is trained to give practical help with your social needs. This might be help with housing problems, financial issues or giving general support and advice.

Community psychiatric nurses (CPNs)
A CPN is a mental health nurse who works in the community. They can support you with taking medication, manage your health and offer you treatment in the community.

Psychologists
A psychologist is someone who is specialises in how people’s thoughts and feelings affecting their behaviour. They offer psychological therapy. They are not normally medically trained.

Occupational therapists
An occupational therapist can help you overcome difficulties with everyday tasks so that you can be as independent as possible.

Other early intervention team professionals
Other people will also make up the service such as managers, psychotherapists, support workers and administrators.

All the staff work together and have meetings to discuss the progress of anyone they support. These meetings are called ‘multi-disciplinary meetings’.

How can I get help from the service?

You usually need a ‘referral’ to get help from the early intervention in psychosis (EIP) service. A referral is when a health professional asks a specialist service for an appointment for you.

EIP services accept referrals from GPs, hospitals and other mental health services in the community. In some areas, the service will let you make an appointment yourself. This is called self-referral.

The EIP service may not accept your referral. If you think that they should have accepted you, you can use an advocate to help you get your point across. If they still do not accept your referral you can make a complaint.

If there are no services for your needs in your area you could ask your GP to make an individual funding request (IFR). This is when your NHS trust will pay for treatment outside your area.

What happens after I have been referred?

If the service accepts your referral, someone will call or write to you and give you an appointment. You will have an assessment during this first appointment. This assessment might be done over a few appointments and can be with more than one professional. This is so that the service can work with you to plan how they can best support you. You should start getting treatment for psychosis 2 weeks after your referral. Treatment may include antipsychotic medication and talking therapy like Cognitive Behavioural Therapy. 

At the assessment, they will ask you about how you are feeling, and what support you already have. Together you will decide how to move forward with your treatment and care. You might get help from one service member or work with a few different members of the service. The assessment and planning of your care should try to meet your needs and what you want. It should not just look at what the professionals and services can offer.

Your GP will still be responsible for the rest of your medical care. If you have a severe mental illness, your GP should offer you a regular physical health check. They have a register that should remind them when this is due.

People with severe mental illness are at higher risk of certain physical health conditions. In your health check a doctor or nurse may take your blood pressure, your pulse, do a urine or blood test or weigh you.

Care Programme Approach

If you have complex needs and need ongoing support, then you might be put under the Care Programme Approach (CPA). The CPA is a framework that organises your mental health care.

If you are on a CPA you should get a care plan and regular reviews. You should also get a care coordinator who will be responsible for your care and support. The care coordinator will be a member of the service. You can still get support from the service even if you are not under CPA.

 

When will I stop seeing the team?

You should be with the early intervention in psychosis (EIP) service for as long as you need it. For most people 3 years is enough time. If you make a good recovery, they can discharge you to your GP or a primary care service that give less intense support.

If you are discharged, but need the service again you have to be referred back to them. If you move to a different area the service needs to make sure that your care is moved to that area. They should keep in touch with you until you are able to work with the new service.

The service should involve you in the discharge process. You can involve family or carers if you would like.

If you do not agree with the service’s decision to discharge you, look at the options for dealing with problems in the next section. 

Problems and confidentiality

You may have some problems with your care or treatment when you are with the early intervention in psychosis (EIP) service. Below are some ways you can try and fix these issues.

Your care coordinator
If you have a care coordinator you can speak to them about any issues that you have with the EIP.

PALS
If you are unhappy with your care, you could contact the Patient Advice and Liaison Service (PALS). PALS can try to help you with any problems or questions you have. There is more information on finding your local PALS in the useful contacts section below.

Advocacy
You can use a community advocate to help talk to your care coordinator or EIP. They can help to make your voice heard and deal with any problems. They may be able to help with writing letters or attending appointments or meetings. Advocates are not part of the NHS.

Complain
You could make a formal complaint if you are unhappy with your care. There will be details on the local trust website about how to make a complaint. You can get help with this from your local NHS Complaints Advocacy Service.

What about confidentiality?

The early intervention in psychosis (EIP) service needs your permission to share information with other people. This includes professionals or your family and friends. They can share information with your GP because they need to be involved in your care. They can share information with other professionals if they are worried that you are a risk to yourself or other people. Or if they are ordered to by a court.

What to expect as a carer, friend or relative

Some early intervention in psychosis (EIP) services may offer you a care plan or an assessment. The assessment will look at the help you need as a carer for someone with psychosis. The EIP will try to get your views and what you think is best for your relative. This will depend on the specific trust policy.

Carers and family members can be helpful in supporting people to get better.14 The service may give you information about your relative’s mental illness and how to support them; this is called ‘psycho-education’. They may offer you practical support if you need it and you should ask them if you do.

The EIP may offer you and your relative a talking therapy called family intervention. This can help to lower stress and cope with psychosis. Family intervention should be given with CBT and medication.

You may also be involved with the care planning. However, there are rules about sharing information with family and carers. The service cannot share information with you or other people unless your relative agrees. You should agree what information your relative is happy for you to know. You can do this with the service and have it written in their records.

If you feel you need support to care for your relative you could ask for a carer’s assessment.

It is important to look after your own emotional wellbeing. You can check if there are any local support groups for carers, friends and relatives. You can contact us to find out what services or groups are in your area.

Patient Advice and Liaison Service (PALS)

You can search for your local PALS service using the following link:

http://www.nhs.uk/Service-Search/Patient-advice-and-liaison-services-(PALS)/LocationSearch/363

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