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• W4313446268 abstract "Introduction Indicated primary prevention of psychosis is recommended by NICE clinical guidelines, but implementation research on Clinical High Risk for Psychosis (CHR-P) services is limited. Methods Electronic audit of CHR-P services in England, conducted between June and September 2021, addressing core implementation domains: service configuration, detection of at-risk individuals, prognostic assessment, clinical care, clinical research, and implementation challenges, complemented by comparative analyses across service model. Descriptive statistics, Fisher's exact test and Mann-Whitney U -tests were employed. Results Twenty-four CHR-P clinical services (19 cities) were included. Most (83.3%) services were integrated within other mental health services; only 16.7% were standalone. Across 21 services, total yearly caseload of CHR-P individuals was 693 (average: 33; range: 4–115). Most services (56.5%) accepted individuals aged 14–35; the majority (95.7%) utilized the Comprehensive Assessment of At Risk Mental States (CAARMS). About 65% of services reported some provision of NICE-compliant interventions encompassing monitoring of mental state, cognitive-behavioral therapy (CBT), and family interventions. However, only 66.5 and 4.9% of CHR-P individuals actually received CBT and family interventions, respectively. Core implementation challenges included: recruitment of specialized professionals, lack of dedicated budget, and unmet training needs. Standalone services reported fewer implementation challenges, had larger caseloads ( p = 0.047) and were more likely to engage with clinical research ( p = 0.037) than integrated services. Discussion While implementation of CHR-P services is observed in several parts of England, only standalone teams appear successful at detection of at-risk individuals. Compliance with NICE-prescribed interventions is limited across CHR-P services and unmet needs emerge for national training and investments." @default.
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• W4313446268 date "2023-01-03" @default.
• W4313446268 modified "2023-10-16" @default.
• W4313446268 title "Mapping the implementation and challenges of clinical services for psychosis prevention in England" @default.
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• W4313446268 doi "https://doi.org/10.3389/fpsyt.2022.945505" @default.
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• W4313446268 hasPublicationYear "2023" @default.
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