Don't Turn Your Back on the Symptoms of Psychosis

West MidlandsMental Health
Published Date: 1 Sep 2015

Don't Turn Your Back on the Symptoms of Psychosis


  • The delay between the onset of a first episode of psychosis and receipt of treatment (DUP) has been consistently shown to predict poorer outcome for young people.
  • However, no strategy to reduce DUP has been proven to be effective in the UK. 
  • This may be because DUP is an inherently complex construct with a variety of potential care pathway delays that may contribute to its duration.
  • Our previous research in Birmingham, identified that long help-seeking delays and delays within mental health services were of prime concern in the care pathways of young people with long DUP.


A quasi-experimental, proof-of-principle prospective study, targeting known sources of delay, to explore whether such initiatives can significantly reduce DUP in Birmingham, UK.


A new youth access pathway for first -episode psychosis was introduced alongside a psychosis awareness public heath campaign. Incident cases of first -episode psychosis were identified and their DUP and care pathways measured. We also used extensive recent DUP data from the NIHR National EDEN study, which was available to define the baseline.


The relative reduction in DUP in the intervention area was 0.735 (95% CI 0.348 to 0.893; p=0.0039) (accounting for baseline period), showing a clear relative reduction.


Whilst our proof-of-principle trial did not include follow - up assessment of clinical symptoms or treatment outcome (issues which should be future priorities in future DUP research), the real world design of our proof-of-principle study was evidence based; targeted known sources of delay in our healthcare setting; was firmly placed in the local context; had strong external validity; had high quality collection of data from a baseline period; and included a prospective control region – increasing the robustness of our evaluation.