Establishing and operating an early intervention service for psychosis in a defined catchment area of northwestern Greece within the context of the local mental health network

摘要

Aim: The study aims to present briefly the development of an early intervention service (EIS) for psychosis in a rural catchment area of north-western Greece within the context of the local mental health network, its structure and procedures, and the results of its operation 2years after its establishment. Method: Established in December 2007, our EIS is the first service in Greece for patients with a first-episode psychosis. The context and the local mental health network are described, and the EIS operation, including clinical, educational, community and research activities, is outlined. Assessment measures are presented to evaluate the EIS progress 2years after its establishment. Results: Between December 2007 and December 2009, EIS received 45 referrals, retaining 38 patients in its caseload. The mean duration of untreated psychosis was 26.6±41.0months (median=12months). Thirty-seven patients (82.2%) were hospitalized after their first referral, 14 under a compulsory order (31.1%). The duration of hospitalization ranged from 2 to 69days, with a median of 13days. Mean (±SD) duration of the follow-up was 14.8±8.5months, indicating adequate adherence to EIS, with particularly low relapse rates (20%). Conclusions: Our EIS seems to be successfully established within the local mental health network. Our collaboration with the local mobile mental health unit enabled our communication with rural primary healthcare centers. The collaboration of patients' family and the participation of the mobile mental health unit to the continuity of care contributed greatly to the brief duration of hospitalization and the high adherence to follow-up rates.