Dr Karen O’Connor, consultant psychiatrist and National Clinical Lead of the National Clinical Programme for Early Intervention in Psychosis, spoke to Drivetime about how psychosis presents through auditory hallucinations and delusions, among other symptoms, and how early interventions can provide better outcomes for patients and be cost-effective in the long run.
Alongside Nicola Byrne, CEO of Shine, Dr O’Connor also discussed the pervasiveness of stigma for those dealing with psychosis, not only in work but also among family and friends. These findings come from a survey carried about by Shine and the National Clinical Programme.
Listen to the Drivetime segment in full on the RTÉ website here, and read selected quotes by Dr O’Connor below.
Read the press statement launching the results of the 2023 survey on stigma among individuals with psychosis.
Early Intervention services have been developed because we know that people with psychosis tend to come to care really, really late. So two or three years after their symptoms have started. And the later that someone comes to care, the worse their outcomes, like you see in most of the rest of health care. And then often the pattern is, you come, they’re in crisis, they’re in the emergency department, they might then have an admission to hospital. You won’t be surprised to know that if that’s your first contact with a mental health service, you probably don’t really want to follow up with them a lot of the time afterwards.
The other big issue in treatment as usual is that the focus is often on medication. And medication can play an important role for people, especially if they are acutely unwell, but actually there’s a big range of evidence-based interventions that in Ireland you can often only access if you are able to access an Early Intervention in Psychosis service. But we only have 5 of those teams across the country and we need about 25.
We’re in this situation where very small amounts of money come available for new developments. We need to change our attitude to mental health. We need to recognise that we need to massively upscale our investment in mental health services. Sláintecare says 10% of our health budget should go to mental health; it’s currently between 5 and 6%. We’re talking about €1.3 billion at the moment, we’re talking about more than €2 billion needs to go into mental health. We need to invest in these excellent services.
Investing in EIP returns on multiple levels. We know from multiple studies that an investment of €1 into an EIP service results in savings of €18 across the system. It reduces relapses, admissions, all of that.