Early intervention services

• Why 'early intervention'?
• Helping people who have 'prodromal’ symptoms
• Do early intervention services make a difference?
• How to contact your local early intervention service

Why 'early intervention'?

The earlier someone who is experiencing symptoms of psychosis gets treatment, the better. A number of research studies have reported that the longer people go without having treatment, the harder it is to start the process of recovery.

Early intervention services are specialist services, available across England (and in many other countries) that provide treatment and support for young people who are experiencing symptoms of psychosis for the first time. Some early intervention services continue to offer specialist support to people for the first few years after they have been given a diagnosis.

Early intervention services are run differently in different parts of the country, but all aim to give people and their families appropriate help, treatment and support – information to help them make sense of what’s happening, for example, talking therapies like family therapy and cognitive behaviour therapy, and medication. The treatment offered by early intervention services should be in line with treatment recommended by the National Institute for Health and Care Excellence (NICE).

Many early intervention teams work closely with other services and agencies to help someone get back to/continue to work or study, sort out benefits and finances and solve any housing problems.

Early intervention teams are usually made up of a range of mental health professionals, including psychiatrists, psychologists, mental health nurses, social workers and support workers. Some teams include vocational advisors or employment support workers. (The Institute of Psychiatry, King's College London, runs an MSc in Early Intervention in Psychosis to train people to carry out specialist early intervention work and to carry out research than can help develop services.) 

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Helping people who have 'prodromal’ symptoms

Some early intervention services also work with young people who are having experiences that could be 'warning signs' and may lead to the development of the symptoms of psychosis. Doctors call these early experiences ‘prodromal’ symptoms.

People may begin to feel confused and find it hard to cope with life, or have unusual and strange experiences, like seeing or hearing things that aren’t there. They may be anxious, or irritable, or depressed, and find it hard to sleep, or need to sleep much more than usual. They may stop wanting to spend time with family members and friends and shut themselves away. They may feel persecuted or harassed (see Paranoia page), or out of control, or feel that something peculiar is happening but not be able to identify what it is.

Researchers describe people who are having these sort of experiences as 'high risk', 'ultra high risk' (UHR), 'clinically high risk' or as being in an 'at risk mental state (ARMS)'. People who have these symptoms are more likely to develop psychosis than their peers.

However, not everyone who experiences prodromal symptoms goes on to develop the symptoms of psychosis. Mental health professionals may therefore suggest talking therapies such as cognitive behaviour therapy and family therapy rather than prescribe antipsychotic medication for people who are experiencing prodromal symptoms. 

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Do early intervention services make a difference?

Researchers have followed people who have been supported by mental health professionals working in early intervention services and compared the course of their illness with the experiences of people who have been treated in general mental health services. The studies have consistently shown that within two years, people who have accessed early intervention services have fewer relapses, are less likely to be admitted to hospital, and have less severe symptoms.

Studies that follow people for more than two years don't always show longer-term benefits for people when they stop receiving specialist support from early intervention services.

Researchers are continuing to track people who have been supported by early intervention services to find out about their recovery progress and relapse rates.

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How to contact your local early intervention service

Ask your GP how to contact your local early intervention service, or visit the website of your local mental health NHS trust and search for 'early intervention'. In some parts of the country, people can ring up and self-refer. Early intervention services aim to see people as quickly as possible.