The International Association for Youth Mental Health held it’s annual conference from October 8th to 10th this year in Montreal. Marie Villeneuve and Amal Abdel-Baki, members of CCEIP, were proud to present the Benchmark Survey results on behalf of the Canadian Consortium for Early Intervention in Psychosis.
For more information on the event see www.iaymh2015.com
New models are emerging in the youth mental health field that embrace therapeutic optimism and incorporate the principals of prevention, early intervention, and recovery. They place young people and their families at the centre of decisions about service and policy development. Youth-friendly accessibility, engagement, and age-appropriate interventions are key to their success.
Building on the highly success and momentum from IAYMH 2013 in Brighton, England, Transformations will focus on how we make the transition from traditional mental health service models to the next generation of programs and services that will better meet the needs of young people and emerging adults. This conference will be an opportunity to showcase current thinking and practice that have emerged since 2013 and will build on the vital contribution that young people made to the conference through an even more robust youth engagement program.
This conference provides an opportunity for health professionals, youth workers, educators, policy makers, young people and family members to come together and learn about new and emerging developments that are striving to make changes that impact globally.
Register before June 19th 2015 to avail of Earlybird Rates. Call for Abstracts will close on April 7th 2015.
Members of CCEIP presented our benchmark survey results to a standing room only crowd at the WPA 2014 and CPA 2014.
Early intervention for psychosis programs (EIPP) have been implemented in Canada without national standards of care. Other countries have developed clinical guidelines, and literature highlights several elements considered as essential. Investigations in other countries have described slow implementation of services and the frequent absence of important components.
The Canadian Consortium for Early Intervention in Psychosis was formed in 2012 : one of its objectives being the development of standards of care, better knowledge of Canadian practices was needed.
An on-line benchmark survey was administered in 2013 to 11 academic FEP clinics in Canada. Questions covered administrative, clinical, education and research topics.
Three Canadian provinces have guidelines; the 5 clinics in those areas follow most of their provincial recommendations.
Most of the 11 programs offer similar services, including case management and various psychosocial interventions, in line with guidelines and expert opinion. However, differences in admission and discharge criteria, services for patients at ultra-high risk (UHR) for psychosis, patient to clinician ratio and existence of specific in-patient units, are observed, and recommendations on those topics are frequently not followed.
Where provincial guidelines exist, programs are more likely to follow recommendations in terms of accessibility, initial assessment of patients, evaluation of program quality and outcome and community interventions for early detection.
Many administrative and organizational elements considered essential in the literature are lacking in Canadian EIPP. The fact that the ones following provincial guidelines perform better in many domains points to the importance of establishing national standards of care.
The CCEIP has received funding to evaluate the profile of clozapine use within the first two years of psychotic illness.
There is consistent and abundant evidence that clozapine is effective in treatment-resistant schizophrenia compared to all other first or second generation antipsychotic agents. Clozapine, even when used, is generally viewed as a ‘last resort’ treatment and, therefore, offered after years of trial with different treatments and often multiple relapse and-or prolonged periods of unremitted states of the illness with chronic and persistent psychotics symptoms with or without negative symptoms. There is now burgeoning literature to suggest that outcome trajectories for psychotic disorders are established relatively early in the course of illness, often within the first two or a maximum of five years (Harris et al 2001) and that this 2-5 year window may be a ‘critical period’ during which success or failure of treatment will have lasting effects on the future course and outcome of the illness in individuals who have to live with it.
It is imperative that we examine the question of the use of clozapine for treatment of psychotic disorders in individuals who have not responded to standard or even enhanced treatment in the early phase of the illness. The social, personal and functional benefits of remission of symptoms at this stage of illness are likely to be much greater than what can be achieved after years of illness, multiple hospitalizations and the demoralization that sets in the more chronic phase of the illness, if symptoms remain unabated.
The Canadian Consortium for Early Intervention in Psychosis will be evaluating the profile of clozapine use within the first two years of diagnosis of non-affective psychosis. Phase one of this project is being funded by Mylan Pharmaceuticals. Phase two of this project is to synthesize the findings from phase one to assist with the generation of recommendations for the use of clozapine in the first 2-5 years of illness.