A study investigating the implementation of NICE recommended psychological interventions for people with psychosis following a psychiatric inpatient admission.

Abstract

The period of time following discharge from an inpatient setting presents a unique window of opportunity for people with psychosis to engage in psychological treatment. In England, The National Institute for Health and Care Excellence (NICE) guidelines outline that every person with a schizophrenia diagnosis should be offered individual Cognitive Behavioural Therapy for psychosis (CBTp) and Family Intervention (FI). This study aimed to explore rates of offer and receipt of NICE recommended therapies for adults with a schizophrenia spectrum disorder diagnosis in the year following discharge from an inpatient unit. We then investigated possible predictors of therapy offer and receipt. We used a large electronic healthcare records database to perform a secondary data analysis. A generalised linear regression model was used to explore possible predictors. Overall, our results showed low rates of offer and receipt of recommended therapies (Any recommended therapy (CBT only, FI only or CBT + FI) received = 39(8%), offered = 70(15%)). Predictor variable results were identified and discussed. The low level of offer and receipt of recommended therapies is concerning given the recommendations in the NICE guidelines for people with psychosis. Our study highlighted the need for more consistent and reliable procedures for recording this information. Further investigation into the reasons for low levels of implementation overall is important to aid the development of recommendations for how this can be improved.