title: Implementation and development of early intervention in psychosis services in Italy: a national survey promoted by the Associazione Italiana Interventi Precoci nelle Psicosi.
abstract: This is the first comprehensive, nationwide survey aimed at collecting evidence about the process of implementation and development of early intervention in psychosis (EIP) services (EIPs) in Italy, following the establishment of the pilot program 'Programma 2000' in 1999 and the publishing of the Italian National Guidelines in 2007. This survey covers all the Departments of Mental Health (DMHs) operating in Italy in 2013.
  
  
  
  Using a purpose-designed form to assess EIP implementation, all directors of public mental health services for adults throughout Italy (n = 216) were asked to provide information about the activities of EIP-relevant local services. The initial delivery was followed by a request for a prompt response.
  
  
  
  Out of 216 enquired DMHs, 103 provided computable answers to the survey (response rate = 48%). Among responders, 45 (44%) reported the implementation of EIP (one out of five DMHs operating in Italy). About a half of the active EIPs also targeted patients at ultra-high risk of psychosis (n = 27). Strict application of guidelines related to drug prescription was reported in 35% of EIPs. Conversely, 90% provided some kind of structured psychotherapy and psychoeducation. Among EIPs, a minority reported willingness to provide initial assessment/contact at the patient's home.
  
  
  
  Albeit slowly, the implementation of EIP is spreading throughout the Italian public network of mental health. There is still a wide variability in the distribution of EIP services across the Italian territory. Further efforts are necessary to stimulate policy endorsement and resource allocation, as well as to support the poorest zones.
authors.affiliation: Programma 2000 - Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Cocchi
authors.affiliation: Programma 2000 - Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Cavicchini
authors.affiliation: Programma 2000 - Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Collavo
authors.affiliation: Department of Neuroscience, Ophthalmology and Genetics, Psychiatry Section, University of Genoa, Genoa, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Ghio
authors.affiliation: Programma 2000 - Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Macchi
authors.affiliation: Programma 2000 - Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Meneghelli
authors.affiliation: Programma 2000 - Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan, Italy.|Psychiatry Branch, Genneruxi Medical Center, Cagliari, Italy.|Center of Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Preti
mesh_terms: D000328:Adult; D004363:Drug Utilization / Q000706:statistics & numerical data; D061345:Early Medical Intervention / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D008605:Mental Health Services / Q000706:statistics & numerical data*; D016730:Program Development / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000188:drug therapy / Q000628:therapy*; D011795:Surveys and Questionnaires
keywords: early intervention; early psychosis; psychiatric service; ultra-high risk