{"id":14955,"date":"2011-10-17T13:09:05","date_gmt":"2011-10-17T17:09:05","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=14955"},"modified":"2011-10-17T15:11:40","modified_gmt":"2011-10-17T19:11:40","slug":"standing-room-only","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2011\/10\/17\/standing-room-only\/","title":{"rendered":"standing room only? down under…"},"content":{"rendered":"
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EPPIC disagreement over early intervention: poll<\/font><\/strong>
Psychiatric Update [Australia]<\/font><\/strong>
by Michael Slezak
October 6, 2011 <\/div>\n

Almost 60% of psychiatrists think the Federal Government’s focus on EPPIC is inappropriate, a poll conducted by Psychiatry Update reveals. Psychiatrists also mostly oppose the similar focus on headspace, but in slightly smaller numbers, with 53.7% either disagreeing or strongly disagreeing that the focus is appropriate. A significant proportion of psychiatrists were unsure about the two approaches, leaving only 30% agreeing the focus on headspace or EPPIC was appropriate…<\/sup><\/p>\n

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Intervening early: solid services or false promises?<\/font><\/strong>
Psychiatric Update [Australia]<\/font><\/strong>
by Michael Slezak
October 6, 2011<\/div>\n

The evidence for early intervention in psychosis has split psychiatrists, but there’s no doubt in Professor Patrick McGorry’s mind that the approach works. The EPPIC centres he has pioneered are based on what is “demonstrably the most evidenced based model in the spectrum of mental health care”, he says. Speaking with Psychiatry Update, he compares the approach of EPPIC and headspace to that used in oncology where intervening aggressively early in cancer can dramatically improve the final outcomes of the disease. <\/sup><\/p>\n

As evidence, he cites two studies from Denmark and Britain showing that early, assertive and intensive treatment improves psychotic and negative symptoms while the treatment is ongoing, compared with patients merely being offered contact with a community mental health centre. But crucially, these studies also show there isn’t, at this stage, much reason to believe the intervention changes the course of the illness…<\/sup><\/font><\/strong><\/p>\n

But others, including Professor David Castle, chair of psychiatry at St Vincent’s Health in Melbourne, say studies such as this show the money being poured into early psychosis has been committed on a false premise: that it will change the course of young people’s illnesses. Asked about this line of argument, McGorry says it seems bizarre to argue against providing psychological services to young people who want them, adding the onus of proof should be on those who want to limit the approach. <\/sup><\/p>\n

But Castle says specialised youth intervention services are problematic for several reasons. “What’s very clear is that good treatments work while they’re being given,” he tells Psychiatry Update. “But boutique stand-alone services are very bad. They’re bad for patients because they have to transition between different forms of care. They’re bad for staff because people get into siloed services like EPPIC and they lose their skills with dealing with people further down the trajectory.” Echoing the concerns of many psychiatrists who commented in our survey, Castle says: “Everybody deserves the best care at whatever age they are, at whatever age of onset they are and at however far along the trajectory of illness they are”…<\/sup><\/div>\n<\/blockquote>\n
Fact is – both sides of that argument sound a bit off.<\/em> In this and other discussions, Dr. McGorry keeps bringing up the studies in Denmark and Britain [summarized below]. I liked them myself:<\/div>\n

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Denmark<\/font><\/strong><\/u><\/div>\n