Research Finds Significant Shortfalls In Early Intervention Psychosis Services

A survey of early intervention services for people suffering from psychosis has found medical care is not being provided early enough, with many patients not seen until after they have been hospitalised. Researchers say these shortfalls are linked to a lack of resources.

“A key purpose of early intervention is to provide care before a person’s condition worsens and they need hospital treatment. However, we found the ‘early’ part of early psychosis care is significantly lacking in New Zealand,” said Dr Rebecca Grattan, lead author of the study and a psychology lecturer at Te Herenga Waka—Victoria University of Wellington.

The study surveyed all 12 early intervention psychosis services in New Zealand, assessing them against international standards for care. These services were set up to provide treatment for people suffering from psychosis symptoms, such as hallucinations and delusions, in the first two years of symptoms occurring.

“One of the accepted international standards for early psychosis care is that at least 80 percent of patients are seen before their symptoms are so severe they end up in hospital. However, just one of the 12 services we surveyed was able to meet this standard,” said Dr Grattan.

The study also found most services restricted access by setting age limits for treatment.

“Age limits for care differed across the services. The lower end of the age range varied from 13 to 18 years and the upper end from 25 to 30 years. While younger people are more at risk of psychosis, people in older age groups can also experience symptoms. Age restrictions mean there will be at-risk people who won’t be eligible to receive care.”

A lack of services in some areas, particularly rural areas, was also identified by the study.

“Some areas don’t have a dedicated early intervention psychosis service. This is more likely to affect people living in rural areas, including rural areas with a high Māori population, which are not well-served.”

When early intervention services can be accessed, the survey results suggest the care patients receive is comparable to that in Canada and California where similar studies have been done, said Dr Grattan.

“Services in New Zealand appear to be meeting many of the standards considered to be best practice, such as completing comprehensive initial assessments and providing care for up to two years. The big problem they face is having the resources to provide care early enough to everyone who needs it,” she said.

Results of the study have been published in the journal Early Intervention in Psychiatry. The study was carried out from 2022 to 2024.

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