Grattan Rebecca E, Clifford Amanda, London Sophie M, Cowland Joanna
School of Psychology, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand.
Department of Psychology, University of Otago, Dunedin, New Zealand.
Early Interv Psychiatry. 2025 Feb;19(2):e70009. doi: 10.1111/eip.70009.
It has been over 20 years since a review of early psychosis services in New Zealand was completed, and it is unclear if services now meet international best practice. Furthermore, significant disparities in psychosis experiences exist in New Zealand, and it is unclear whether service structure might contribute to such disparities. Given the current restructuring of the health system in New Zealand, now is the optimal time to understand strengths and weaknesses in early psychosis care provision.
All early psychosis services in New Zealand (n = 12) were surveyed. Leads from each service completed a survey on the general elements of their service, alongside the First-Episode Psychosis Services Fidelity Scale, which allows comparison with international early psychosis services.
Specific services are provided across 11/20 districts, leaving 9 without any dedicated early psychosis care. Service strengths included short wait lists, comprehensive assessments, good provision of case managers, team managers and psychiatrists and good length of care. Relative weaknesses included provision of therapy, limited age ranges, high numbers of inpatient referrals, poor Clozapine usage and limited family participation. There was also a lack of services for people at risk for psychosis. Lack of cultural support staff, models and confidence in meeting cultural needs was also evident.
While New Zealand early psychosis services are relatively comparable to international services, certain areas of weakness need to be addressed by decreasing variability in service eligibility, increasing care for those at-risk, wider availability of therapy and family involvement and improved cultural services.
新西兰对早期精神病服务的审查已过去20多年，目前尚不清楚这些服务是否符合国际最佳实践。此外，新西兰在精神病体验方面存在显著差异，尚不清楚服务结构是否可能导致这种差异。鉴于新西兰目前的卫生系统重组，现在是了解早期精神病护理服务优缺点的最佳时机。
对新西兰所有早期精神病服务机构（n = 12）进行了调查。每个服务机构的负责人完成了一份关于其服务一般要素的调查，同时还完成了首发性精神病服务保真度量表，该量表可用于与国际早期精神病服务进行比较。
在20个地区中的11个提供了特定服务，有9个地区没有任何专门的早期精神病护理服务。服务优势包括等待名单短、评估全面、个案经理、团队经理和精神科医生配备良好以及护理时长适宜。相对薄弱环节包括治疗服务提供、年龄范围有限、住院转诊数量多、氯氮平使用情况不佳以及家庭参与度有限。此外，也缺乏针对有精神病风险人群的服务。文化支持人员、模式以及满足文化需求的信心不足也很明显。
虽然新西兰早期精神病服务与国际服务相对可比，但某些薄弱领域需要通过减少服务资格的差异、增加对高危人群的护理、更广泛地提供治疗和家庭参与以及改善文化服务来加以解决。
