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State of the Art 1

Early Intervention as a Priority for World Psychiatry

Professor Helen Herrman

Orygen, The National Centre of Excellence in Youth Mental Health and The University of Melbourne, Australia

Successful approaches to early intervention in psychiatry need to be developed worldwide.
While much of the research on early intervention in psychiatry is conducted in high-income
countries, the work is highly relevant to low-income countries where the treatment and research gaps
are wider. Experience from the rest of medicine and the growing evidence for effective early
intervention suggest that the effective and efficient response in all countries to mental health needs
will include attention to early intervention.

Early case identification and intensive treatment of a first episode of illness was proposed as
a preventive strategy for psychotic illnesses in the 1990s. Since then, evidence has accumulated
demonstrating that early intervention leads to better clinical and functional outcomes for patients, at
least while this model of care is maintained, and is more cost-effective than standard care. The work
has since been extended to include mental illnesses of other types. The presentation will consider the
work of non-government organisations in low-income countries to give an indication of feasible
early intervention at low cost along with community-based rehabilitation. The presentation will also
consider the community partnerships that are essential to this work. Effective links between
psychiatrists, community leaders, patients and families, based on negotiation and mutual respect, are
important for the support of early intervention in psychiatry.