Implementation of early intervention clinical services within the National Health System in Italy: Third wave survey with focus on structures, resources, and fidelity to the evidence-based model.

Publisher: Wiley-Blackwell Country of Publication: Australia NLM ID: 101320027 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1751-7893 (Electronic) Linking ISSN: 17517885 NLM ISO Abbreviation: Early Interv Psychiatry Subsets: MEDLINE

Original Publication: Carlton,VIC, Australia : Wiley-Blackwell

Psychotic Disorders*/diagnosis ; Mental Health Services*; Humans ; Reproducibility of Results ; Italy ; Surveys and Questionnaires

Background: Early intervention in psychosis (EIP) is a well-established approach aimed at detecting and treating early signs and symptoms of psychosis to prevent its long-term consequences. The present study aimed at detailing the current status of EIP services in Italy, covering all the Departments of Mental Health (DMHs) operating in 2018.
Methods: All directors of public DMHs operating in Italy in 2018 (n = 127) were invited to fill in a Census form about EIP structure and activities. The first episode psychosis services fidelity scale (FEPS-FS) was used to investigate fidelity to the EIP model of the centre.
Results: An active EIP service was reported by 41 DMHs (32% of the total DMHs; 56% of those who took part in the survey). Most EIP services had an autonomous team. The large majority of the Italian EIP centres provided psychosocial interventions to their patients, principally psychotherapy, family support, and psychoeducation. Among those with an active EIP, 29 DMHs filled in the FEPS-FS. Internal consistency was good when based on the replies of the respondents, but reliability was weak when measured on the basis of an independent evaluation (Cohen's kappa = 0.571). The fidelity to the guidelines for early intervention was uneven, with some criteria met by most centres, especially those peculiar to the Italian community psychiatry.
Conclusion: A further spreading of the early intervention model across the Italian DMHs was found. A lack of resources might limit the use of specific psychosocial treatments, such as cognitive-behavioural therapy or manualized family support.
(© 2023 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.)

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Keywords: community mental health services; early intervention; early psychosis; guidelines; schizophrenia; ultra-high risk

Date Created: 20230122 Date Completed: 20230907 Latest Revision: 20230908

20230909

10.1111/eip.13380

36682817