title: Don't turn your back on the symptoms of psychosis: the results of a proof-of-principle, quasi-experimental intervention to reduce duration of untreated psychosis.
abstract: BACKGROUND
  No evidence based approach to reduce duration of untreated psychosis (DUP) has been effective in the UK. Existing interventions have many components and have been difficult to replicate. The majority of DUP in Birmingham, UK is accounted for by delays within mental health services (MHS) followed by help-seeking delay and, we hypothesise, these require explicit targeting. This study examined the feasibility and impact of an intervention to reduce DUP, targeting help-seeking and MHSs delays.
  
  
  METHODS
  A dual-component intervention, comprising a direct care pathway, for 16-25 year olds, and a community psychosis awareness campaign, using our youth-friendly website as the central hub, was implemented, targeting the primary sources of care pathway delays experienced by those with long DUP. Evaluation, using a quasi-experimental, design compared DUP of cases in two areas of the city receiving early detection vs detection as usual, controlling for baseline DUP in each area.
  
  
  RESULTS
  DUP in the intervention area was reduced from a median 71 days (mean 285) to 39 days (mean 104) following the intervention, with no change in the control area. Relative risk for the reduction in DUP was 0.74 (95% CI 0.35 to 0.89; p = .004). Delays in MHSs and help-seeking were also reduced.
  
  
  CONCLUSIONS
  Our targeted approach appears to be successful in reducing DUP and could provide a generalizable methodology applicable in a variety of healthcare contexts with differing sources of delay. More research is needed, however, to establish whether our approach is truly effective.
  
  
  BACKGROUND
  ISRCTN45058713 - 30 December 2012.
authors.affiliation: University of Warwick, Warwick, UK. charlotte.connor@bsmhft.nhs.uk.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Connor
authors.affiliation: University of Warwick, Warwick, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Birchwood
authors.affiliation: University College London, London, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Freemantle
authors.affiliation: University of Warwick, Warwick, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Palmer
authors.affiliation: University of Warwick, Warwick, UK.
authors.forename: Sunita
authors.initials: S
authors.lastname: Channa
authors.affiliation: Birmingham & Solihull Mental Health NHS Trust, Centre for Mental Health The Barberry Centre, 25 Vincent Drive, Birmingham, B15 2FG, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Barker
authors.affiliation: Birmingham Children's Hospital, Birmingham, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Patterson
authors.affiliation: University of Warwick, Warwick, UK.
authors.forename: Swaran
authors.initials: S
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult