ABSTRACT
AIM: To review the baseline and clinical characteristics of patients referred to a New Zealand Early Psychosis Intervention (EPI) service across a 4-year timeframe. METHOD: We compared two cohorts, and identified variables associated with being accepted or declined, and reasons for decline, by an EPI service between 2013 and 2017. RESULTS: There were 576 people with suspected psychosis referred to the EPI service for assessment: 300 (52%) were accepted, 221 (38%) declined and 55 (10%) were not processed. Reasons for being declined by EPI services were a long duration of psychosis (DUP, 48%) and no evidence of psychosis (47%). There were no significant differences between the accepted and declined group in Emergency Department presentations for self-harm or suicide attempts and acute admissions to a psychiatric inpatient unit over the 3-year follow-up period. CONCLUSION: To optimise the identification of true positive cases, EPI services require clear entry criteria. Replicating this study in other EPI services with different entry criteria may provide evidence to develop a more uniform screening process. Improved outcomes may be enhanced by measuring effectiveness and liaising with other EPI services.
ABSTRACT
OBJECTIVE: In this study, we aimed to identify service user demographic and clinical characteristics of an acute mental health service in South Auckland during the first New Zealand coronavirus-related lockdown. METHOD: We conducted a clinical audit of a sample of service users presenting to a district health board's acute adult mental health service during New Zealand's level-4 lockdown in 2020 and made comparisons to a sample from 2019. We identified demographic factors, living situation, mode of referral, mode of assessment, diagnosis, substance use, risks, stressors, use of mental health act legislation and follow-up. RESULTS: During the first level-4 lockdown fewer Ma¯ori were assessed, police referrals increased, specific stressors related to confinement were identified and there was an increase in risks relating to self-harm and harm to others. CONCLUSION: Service users had unique stressors and changing patterns of presentation during the level-4 New Zealand lockdown. In response to the changing needs of service users during a pandemic, we recommend optimising telehealth, enhancing connections with other essential services, development of digital interventions and care for frontline staff.
