Don't turn your back on the symptoms of psychosis: a community campaign to improve the care pathways of young people with psychosis

ISRCTN ISRCTN45058713
DOI https://doi.org/10.1186/ISRCTN45058713
Secondary identifying numbers N/A
Submission date
22/11/2012
Registration date
30/11/2012
Last edited
31/10/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
First-episode psychosis refers to the first time someone experiences psychotic symptoms or a psychotic episode. Young people are particularly vulnerable to developing psychosis; symptoms can be very disturbing and confusing and can include hallucinations, delusions and feelings of paranoia. Distress may be further increased by negative myths and stereotypes that are present in our society about mental illness. International studies have shown that some young people with psychosis can experience long delays in getting treatment (duration of untreated psychosis or DUP). Such delays can have important consequences for their treatment response and long-term outcome. The main sources of long delays are often due to poor help-seeking behaviour and delays within mental health services themselves, suggesting the need for greater focus on the sources of these delays in tackling them. The aim of this study is to reduce these long delays (or DUP) and improve the care pathways of young people experiencing first-episode psychosis by carrying out a psychosis awareness public health campaign which will run alongside a new ‘youth access’ mental health service. These interventions will provide information and guidance on when, where and how to seek help for psychosis, and provide a single referral point for young people with first-episode psychosis, to ensure they receive care from a youth sensitive team and guarantee direct access to a specialised service.

Who can participate?
The psychosis awareness campaign is aimed at young people (aged 14 – 30) in the south of Birmingham who may be experiencing symptoms of psychosis, their carers and those who work with young people, to raise awareness and provide information about when, where and how to seek help. Alongside provision of a bespoke youth mental health website (www.youthspace.me/psychosis) and a psychosis information line, the campaign will use media, advertising and community events to engage with the south Birmingham community, situating itself in local shopping centres, supermarkets and employment centres. It will also collaborate with youth, community and education groups.

What does the study involve?
The youth access team will operate alongside existing CMHTs in the south of Birmingham to provide direct referral channels and immediate assessments for all young people presenting to primary care with mental health difficulties. DUP and numbers of young people with first-episode psychosis entering the youth access team from the intervention area will be compared with the DUP and numbers of young people with first-episode psychosis entering services from the rest of Birmingham.

What are the possible benefits and risks of participating?
There are no risks from participation as DUP is routinely collected at entry into specialist services as part of initial assessments of all young people with first-episode psychosis.

Where is the study run from?
The awareness campaign and the youth access team are both based in south Birmingham and will operate as a pilot study which will inform a definitive trial.

When is the study starting and how long is it expected to run for?
The study began in January 2012 and will run for 18 months.

Who is funding the study?
The study is funded by the National Institute of Mental Health (UK).

Who is the main contact?
Dr Charlotte Connor
c.s.connor@bham.ac.uk

Contact information

Prof Max Birchwood
Scientific

University of Birmingham
School of Psychology
Frankland Building
Edgbaston
Birmingham
B15 2TT
United Kingdom

Email m.j.birchwood.20@bham.ac.uk

Study information

Study designThis is a quasi-experimental, proof-of-principle prospective trial comparing an intervention area in the south of the city, to the non-intervention remainder of the city.
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typePrevention
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleDon’t turn your back on the symptoms of psychosis: a proof-of-principle, quasi-experimental public health trial to reduce the duration of untreated psychosis in Birmingham, UK.
Study objectivesWill implementation of a psychosis awareness public health campaign, in addition to a youth access pathway for first episode psychosis, significantly reduce duration of untreated psychosis (DUP).
Ethics approval(s)Not provided at time of registration
Health condition(s) or problem(s) studiedFirst-episode psychosis
Intervention1. Psychosis Awareness Campaign
To improve the help-seeking of young people and their carers, who are experiencing symptoms of first-episode psychosis providing information about when, where and how to seek help. Individuals are encouraged to access a helpline and a bespoke website.
The campaign will comprise of the following elements:
1.1. Advertising in high use settings.
1.2. Leaflet drops
1.3. Advertising in community press
1.4. Advertising on community websites
1.5. Attendance at community events
1.6. Promotion of www.youthspace.me/psychosis
1.7. The Psychosis Information line
1.8. Youth Advisors
1.9. Psychosis Awareness Training
2. Youth mental health care pathway - to improve the care pathway.
Intervention typeOther
Primary outcome measureDUP is routinely assessed for all young people entering services as part of their clinical assessment. Incident cases of first episode psychosis will be determined and their DUP and care pathways ascertained over the 18 months period.
Secondary outcome measures1. Increase in referrals of young people diagnosed with a psychotic disorder from the intervention area into EIS.
2. We also benefit from historical DUP data (National EDEN) 19 (August 2005 – June 2009) for both target and control areas
Overall study start date07/01/2012
Completion date07/09/2013

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participantsA proof-of–principle trial, key outcome will be an estimate for a definitive trial. The population of our intervention are the size of the community we are trying to target (308,150)
Key inclusion criteriaAll new cases of first episode psychosis accepted by the Early Intervention in psychosis Service.
Key exclusion criteriaPatients considered at ultra-high risk of psychosis are excluded. Since this is a pragmatic trial focussing on reducing DUP in patients managed within an EIS, there will be no other exclusions
Date of first enrolment07/01/2012
Date of final enrolment07/09/2013

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University of Birmingham
Birmingham
B15 2TT
United Kingdom

Sponsor information

National Institute of Health Research [NIHR] (UK)
Government

Room 132
Richmond House
79 Whitehall
London
SW1A 2NS
United Kingdom

Email enquiries@nihr.ac.uk
Website http://www.nihr.ac.uk/
ROR logo "ROR" https://ror.org/0187kwz08

Funders

Funder type

Government

NIHR CLAHRC Programme for Birmingham and the Black Country (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing planNot provided at time of registration

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 22/02/2013 Yes No
Results article 04/05/2016 31/10/2022 Yes No

Editorial Notes

31/10/2022: Publication reference added.