I recently read a superb article on early intervention in psychosis in ‘The Health Service Journal’ dated 23rd November, 2006 (1). It is about the service at Birmingham and Solihull Mental Health Trust and how it helped a young Asian man of 25, diagnosed as suffering from Manic Depressive Psychosis.

Such services are of proven effectiveness in reducing in-patient admissions into mental health beds and in reducing re-admission rates in psychiatric units. Why are they not the norm now in the UK?

A report by Rethink examined the development of early intervention psychosis teams between 1997 and 2005. It showed that there were 117 early intervention teams in name but only 87 of them had staff. In the south east only 20 per cent of the planned teams were operational, compared with 73 per cent in the Midlands. So had the young Asian Midlander been living in London, he might well be roaming the streets of the capital homeless by now.

Yet, from my last blog you will have read about the staggering wastage of newly qualified nurses to God only knows where, a proportion of whom must be RMN – qualified, and now, conceivably, unemployed.

As an RMN-qualified nurse myself, I would love to have the opportunity, by agreement with my employer, to spend some time in ‘return to practice’ duties helping out my local early intervention psychosis team on my local patch, and yet there is no such mechanism for community involvement offered by my local PCT. However, perhaps I am exhibiting ‘knight’s move thinking’ here? Why can’t PCT’s take a more holistic view of health needs and methods of delivery in their communities? Well, I know they’ve all been worrying about whether they are going to be in a job next week or not for a while now – but that’s how politicians think people working in health need to be motivated. How wrong they are.

We certainly need to rethink these vital community outreach services in psychiatry, particularly in London. Perhaps Nurses for Reform should lobby to meet Professor Louis Appleby, the DoH’s ‘Mental Health Tsar’ on this subject?

What do you re-think?

(1) The Health Services Journal, November 23rd, 2006 pp 22-24 Article by Lynn Eaton.

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