Routine evaluation in first episode psychosis services: feasibility and results from the MiData project.
BACKGROUND
Early intervention services (EIS) for psychosis are becoming widespread. Structured methods of assessment are advocated in these services, but a consensus is still needed on a package of measures with good psychometric properties that is feasible and reliable for routine use in this setting.


METHODS
A computerised assessment package (MiData) was designed to provide clinicians with easy-to-understand feedback about clients' progress and to allow evaluation of the whole service for both audit and research purposes. Core areas include symptoms, duration of untreated psychosis (DUP), pathways into care, social functioning, and substance misuse at initial intake and annually thereafter.


RESULTS
MiData has been adopted by EIS throughout London and in some other centres. Baseline data are now available regarding 533 first-episode psychosis patients who presented to 8 London teams. The completeness of the data varied across teams and measures, with fullest completion for sociodemographic data (99% on some measures) and poorest for DUP. The average London EIS client is male, single, unemployed and comes from Black or Minority Ethnic group. Most (70%) demonstrated poor social functioning at intake, over a third (38%) reported substance abuse problems and 23% had harmed themselves or others in the previous 6 months.


CONCLUSIONS
MiData provides a clinician-friendly system of evaluating first-episode psychosis services but requires further refinement and dedicated resources to improve completion rates. This method of collecting routine data is of use to clinicians, managers, health service researchers and commissioners and potentially it may enable naturalistic comparisons between different models of care.
Institute of Psychiatry, PO80 MRC SGDP Centre, De Crespigny Park, London, UK. h.fisher@iop.kcl.ac.uk
Helen
H
Fisher
Kate
K
Theodore
Paddy
P
Power
Brock
B
Chisholm
Jo
J
Fuller
Karl
K
Marlowe
Katherine J
KJ
Aitchison
Raj
R
Tanna
John
J
Joyce
Maxine
M
Sacks
Thomas
T
Craig
Sonia
S
Johnson
D000293:Adolescent; D000328:Adult; D016208:Databases, Factual; D017831:Diagnosis, Dual (Psychiatry); D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008485:Medical Audit / Q000379:methods*; D008491:Medical Informatics Applications; D008605:Mental Health Services / Q000592:standards*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology; D055815:Young Adult