Enriched intervention

What is enriched intervention?

Enriched interventions are comprehensive treatment paradigms that are specialised for particular illness phases, or extensively tailored to a patient’s individual needs. Such intervention programs for schizophrenia and psychosis are often combined interventions comprising pharmaceutical and psychosocial therapies. Enriched interventions are often applied as early intervention programs in first episode psychosis or schizophrenia.

What is the evidence for enriched intervention?

Moderate to low quality evidence suggests enriched interventions may be more effective than standard care for improving symptom severity, but not for improving functioning.

 

June 2016

Integrated care

What is integrated care?

Integrated care refers to the association of multiple treatment paradigms to produce a single unified program. The idea is to deliver seamless care to the patient to ensure high treatment continuity and improve patient satisfaction. Integrated programs typically involve multi-element psychosocial therapies for mental illness. For example, integrated psychological therapy involves a combination of cognitive training, social skills training, problem-solving training and cognitive remediation. Integrated care can also refer to the formal liaison of typically distinct services such as medical practitioners and dedicated mental health teams, or the incorporation of mental health and substance use treatments into a single program.

What is the evidence for integrated treatment programs?

High quality evidence suggests integrated psychological therapy provides benefit for symptoms, global state, functioning and cognition over standard care. Moderate to low quality evidence suggests integrated psychological therapy provides benefit regardless of treatment settings or assessment format, and is most effective for patients with stabilised symptoms rather than acute symptoms. Moderate to low quality evidence suggests benefit of integrated medical and mental health care for improving health outcomes and treatment needs, increasing contact with services, and improving patient satisfaction.

 

June 2016

Quality of care

What is quality of care?

Quality of care refers to the standards of treatment provided to people with schizophrenia. This topic considers not only the availability of various types of treatment, but also the factors influencing successful treatment outcomes in physical and mental health-care models.

What is the evidence for quality of care?

Moderate to low quality evidence finds essential structural indicators for ensuring high quality health care delivery include the assessment of psychiatric and somatic comorbidity, length of hospitalisations, employment outcomes, and information exchange. Essential quality indicators for patient-related assessment of treatment outcomes include the frequency of access to psychiatric care, frequency of inpatient re-admission, frequency of antipsychotic polypharmacy, long-term monitoring of antipsychotic side effects, and frequency of involuntary admissions.

Inpatient education programs are helpful, particularly for learning about schizophrenia diagnosis and medication management. Programs that involve patients in the planning and detailing of information to make them more individualised are the most helpful.

 

March 2019