Early intervention in psychosis: Health of the Nation Outcome Scales (HoNOS) outcomes from a five-year prospective study

Highlights

•Specialist programs for early intervention in psychosis are based on sound clinical practice guidelines.
•Routine outcome measures (ROMs) are an under-used resource for evaluating nursing practice and mental health programs.
•Most early psychosis programs (EPP) target youth populations.
•Analysis of ROMs over 5 years for one EPP shows good outcomes.
•Specialist EPPs can show good outcomes for broader adult EP populations.

Introduction

Over the last two decades, mental health services internationally have shifted towards intervening early in psychosis. The critical period for intervention is estimated to be five-years and many specialised programs target early psychosis.
Aim/question

This prospective cohort study aimed to evaluate five-year outcomes from an early psychosis program (EPP) that adopted an integrated model, providing nursing and multidisciplinary community mental healthcare to clients aged 16–65 years, beyond the typical age range of 16–25 years.
Method

We examined one routine outcome measure, the Health of the Nation Outcome Scales (HoNOS) across episodes of care for clients receiving EPP over a 5 year period (n = 239), comparing these results with HoNOS outcomes in an Australian national dataset for all public mental health clients.
Results

HoNOS improvements were highly significant from intake to discharge and from review to discharge for EPP clients, and these compared well with national outcome performance.
Conclusion

There is potential for mental health nurses and other clinicians to significantly improve client symptoms and functioning, in a model of early psychosis treatment beyond a youth focus.

http://www.psychiatricnursing.org/article/S0883-9417(16)30338-7/fulltext?rss=yes

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