Debate: Better use of existing services, not more new pathways, is required for psychosis prevention in young people – Commentary on Salazar de Pablo and Arango: ‘Prevention of psychosis in adolescents: does CAMHS have a role?’

Abstract

Background

There has been much academic interest in ‘the clinical high-risk state for psychosis’ (CHR-P) concept. Whilst early intervention in psychosis (EIP) services have offered input to individuals meeting the CHR-P criteria the involvement of CAMHS clinicians in supporting young people with ideational and perceptual disturbance has been more inconsistent and uncertain.

Method

We bring together our relevant lived experience, empirical evidence and clinical and research expertise to write this commentary.

Results

We assert that the CHR-P paradigm needs to be revised. This should reflect the low transition rates to psychosis and the prevalent general, impairing psychopathology in individuals meeting these criteria. Nevertheless, it is clear that both CAMHS and EIP services have potential roles in meeting the needs of young people affected by distressing ideational and perceptual disturbance.

Conclusions

We suggest that new care pathways and services are not required for young people affected by distressing psychosis-like experiences. Rather more effective joint working between CAMHS, EIP, crisis services and other agencies could meet the needs of these young people more comprehensively.