Ashok Malla is with the Department of Psychiatry, McGill University, and Douglas Mental Health University Institute, Montreal, Quebec. Patrick McGorry is with Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia, and the Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
Am J Public Health. 2019 Jun;109(S3):S181-S184. doi: 10.2105/AJPH.2019.305018.
Over the past two decades or more, the creation of early intervention services (EIS) for psychoses has been regarded as one of the most significant developments in the reform of mental health services. The development of EIS is based on evidence of their superior effectiveness on multiple domains compared with regular care and the well-established relationship between delay in treatment of psychosis and outcome. The benefits of EIS may, however, be underutilized because of a patchy implementation even within high-income countries, low attention to actively reducing delays in treatment, inadequate knowledge about the length and dose of EIS required, and a lack of a population perspective in research and service planning. In this commentary, we offer some suggestions of how to address these challenges.
在过去的二十年或更长时间里,为精神病创建早期干预服务(EIS)被认为是精神卫生服务改革的最重要进展之一。EIS 的发展基于它们在多个领域优于常规护理的有效性证据,以及精神病治疗延迟与结果之间的既定关系。然而,即使在高收入国家,EIS 的实施也参差不齐,对积极减少治疗延迟的关注不足,对 EIS 所需的长度和剂量的了解不足,以及在研究和服务规划中缺乏人口观点,这可能导致 EIS 的益处未得到充分利用。在这篇评论中,我们提出了一些如何应对这些挑战的建议。