The issue of five year outcomes in early intervention in psychosis--consequences for the design of services.

Early intervention for psychosis services have been a very important area of development in Community Mental Health in recent years. Here we attempt to describe the general principles on which early intervention services are based, the interventions which such services carry out, and the expected outcomes according to the latest literature. While there is consensus that at 3 years after the first episode, outcomes from an ad hoc Early Intervention Team are better than treatment as usual in a Community Mental Health Team. It has been found in most studies, that if patients are treated in an Early Intervention Team for three years, and then transferred back to a Community Mental Health Team, the improvement in outcomes is lost. The reasons for this are described. The Implications for services are that, if outcomes are to be optimised in the treatment of schizophrenia, then assertive treatment in the community needs to be given for as long as possible.