Briefing: Early Intervention in Psychosis (EIP)

What are Early Intervention in Psychosis (EIP) Services?

EIP services are multidisciplinary community mental health services that provides treatment and support to people experiencing or at high risk of developing psychosis. This support typically continues for three years. EIP services offer a range of interventions which fall under the umbrella of seven key components according to NICE recommended interventions for adults with psychosis.

Foremost, is a comprehensive multidisciplinary assessment which takes into consideration several factors, not only the psychiatric, medical, and physical health but also social, occupational, and economic elements. Some interventions are focused on reducing the severity of symptoms, distress experienced and general wellbeing such as antipsychotic medication, CBT for psychosis and physical health interventions and monitoring. While others are more holistically offered depending on circumstance such as family intervention, carer-focused education and support programmes and supported employment programmes and vocational rehabilitation, with an aim to improve social, economic and recovery. 

Why are Early Intervention in Psychosis (EIP) Services so important?

The NICE guideline on implementing access and waiting time standards for EIP, which primarily offers guidance for professionals looking to put EIP services into place also explores some of the reasons why it is such an important service, explaining:

The impact of psychosis - Due to the nature of psychosis and psychotic disorders having the potential to be extremely debilitating, people who do not access effective treatment quickly are far more likely to experience poor physical health, lower levels of social functioning and poorer occupational and educational outcomes.

The effect of timely treatment - People who experience psychosis can and do recover; people who receive the right treatment at the right time from an EIP service can go on to lead full, hopeful, and productive lives. Crucially, the time from onset of psychosis to the provision of evidence-based treatment has a significant influence on long-term outcomes. The sooner treatment is started the better the outcome and the lower the overall cost of care.

The economic benefits - The short and longer-term economic benefits of EIP services are significant, with estimated net cost savings of £7,972 per person after the first four years, and £6,780 per person in the next four to 10 years if full EIP provisions are provided. Over a 10-year period this would result in £15 of costs saved for every £1 invested in EIP services.

In 2014, Rethink Mental Illness published the report, Investing in Recovery: Making the business case for effective interventions for people with schizophrenia and psychosis that outlined the many other benefits of EIP services, which include:

Reduced suicide rates – EIP services have been found to reduce the risk of a person experiencing psychosis taking their own life from 15% to 1%.

Improved physical health – part of EIP services’ holistic approach is a focus on supporting people’s physical health. This is particularly important given that people experiencing psychosis can experience very poor physical health as a result of medication side effects, such as rapid weight gain, and other factors. This contributes to people with psychosis dying, on average, 15-20 years younger than the general population, often from preventable physical health conditions.

Reduced demand on other services – people who receive EIP support are less likely to need more expensive mental health services and are less likely to be detained under the Mental Health Act.

Improved employment and education prospects – young people receiving care are more likely to gain employment (35%) compared to those receiving standard medical care (12%).

For more information on implementing EIP services you can find further NICE guidance here. Additionally, the National Clinical Audit for Psychosis (NCAP) produces an annual report on EIP services and includes recommendations for improvement.

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