First episode of psychosis - an audit of service engagement and management at 1-2 year follow-up.

ABSTRACT

BACKGROUND: The study aimed to develop and implement local audit standards for management and service engagement in the follow-up of patients suffering from a 'first episode of psychosis'. MATERIAL AND METHODS: Audit standards, developed following a literature review and consultation with colleagues, were incorporated into a questionnaire for distribution to the community keyworkers of a 'first episode of psychosis' cohort at 1-2 years of follow-up. RESULTS: Most satisfied standards for engagement (91%) and maintenance medication (91%). Forty-two to sixty-three per cent had received psychological, family and educational interventions but these often lacked theoretical basis and detailed content. Admission, deliberate self-harm and forensic contacts were infrequent. Less than half had any structured daytime activity. Priorities identified for improving services for this group include adequate staff training in psychosocial interventions and more active planning and resourcing of day care and other constructive daytime activities. CONCLUSIONS: Simple locally-developed audit standards such as those described for a 'first episode of psychosis' population can offer a useful way of assessing service delivery and highlighting areas for development.