What are the benefits of early intervention services and how do you know they work?

Professor Philip McGuire: The benefits that you might see would be a reduced need for the admission to hospital, a reduced amount of the time in hospital, a reduced need for compulsory treatment – so that means treatment involving a Section of the Mental Health Act, less severe symptoms at follow-up, and a better functional outcome at follow-up – so that might mean being able to return work as opposed to being unemployed.

One of the crucial issues for early intervention services is that while everyone instinctively thinks it’s logical to try and intervene as early as possible in any disorder, it’s critical to assess in an objective way whether these services work because there is a cost to providing these services, and so there’s been a number of studies that have evaluated the introduction of a new early intervention service and compared that to people who were treated by a non-early intervention route.

One can compare the outcome after a period of time, people who have had, from the same area, who have been treated in 2 different ways. And a number of studies suggest that access to early intervention services does improve outcome in terms of symptoms, and in terms of function in the short term. The key issue, for the field now, is whether these benefits persist in the longer term, so after 5 or 10 years or longer, and these studies are only just being done now, and while they look promising, it’s still not clear, simply because the services haven’t been around long enough to, in a large scale way, look at long-term outcome.