Early Intervention in Psychosis

Psychosis is more common than you may think. Research shows that people are most likely to experience psychosis for the first time in their late teens to early thirties, but it can happen for many different reasons. 

This could be because of increased stress from a change in circumstances, or addiction to substances like drugs.

You may feel that something isn't right, but can't quite identify what the problem is.

Early signs can sometimes be unclear and hardly noticeable. A person with psychosis might experience the following:

• Seeing, hearing or feeling sensations of things that aren’t there (hallucinations)
• Feeling as though an outside force or person is interfering with your thoughts or actions, known as ideas of reference
• Thinking that people are conspiring against you (paranoia), that you have special powers or skills, or that people on TV or the radio are talking to or about you (delusion)
• Having constant trouble putting thoughts in order or keeping track of usual tasks, also known as thought disorder

The symptoms of psychosis vary a lot between individuals and you might not experience all of the signs here.

See a list of Psychosis symptoms on the NHS website (opens new browser tab)

Anyone can develop psychosis, and most people recover in less than six months with treatment and support. Early treatment increases the chance of a full recovery. 

Early intervention in psychosis is for anyone aged 14-65 years who is experiencing symptoms of psychosis for the first time for one week or more. The service will also work with people who are at risk of developing psychosis; this may include having a strong family history of psychosis, a decline in social functioning, increased levels of anxiety and some mild psychotic symptoms. 

If you, or someone you care for, require early intervention, we’ll create a care plan with you. The care plan will include:

• Information to help you and your family understand psychosis
• Support with school, college, university or work
• Psychological interventions (CBT)
• Assessment and support to manage health and wellbeing, including healthy eating, physical activity and stopping smoking
• Support with understanding your medication.

We usually meet you within 14 days of your referral, at a time and venue convenient to you. The meeting gives you the opportunity to discuss your experiences and any concerns you have.

In order to make a referral to the Early Intervention in Psychosis team:

• The patient must have experienced a period of psychosis for at least one week
• The period of psychosis needs to have been accompanied by a decline in functioning
• It must be the first episode of diagnosed psychosis and symptoms will have emerged within the past three years
• The patient should not have previously been prescribed anti-psychotic medication.

We usually do not accept referrals for:

• Drug induced cases where psychosis remits once drug use stops, usually within seven days
• Cases where a clear organic cause is evident
• Symptoms which are wholly explicable in the context of post traumatic stress disorder or personality disorder
• Crisis cases, which should be referred to acute services in the first instance.

 Those considered in an At Risk mental state will show the following:

• Experiencing distress
• Be in younger adulthood (typically between 14-30)
• Have evidence of decline in social functioning by 30% over the last year which has been sustained for at least a month.

With at least one of the following:

• Mild psychotic-like symptoms that are distressing but do not meet the threshold for psychotic diagnosis, but significant enough to gain clinical attention (present at least once a week for a month over the last year)
• Frank psychotic symptoms that last for less than one week and resolve spontaneously
• Strong (first degree relative) family history of psychotic illness

Referrals must include a detailed history of the presenting complaint. In borderline cases, strong objective indications such as being at peak age or a first-degree relative, will be taken into consideration.