Table 2.
Elements rated essential with good consensus
| Element | Grouping |
| The EIS should deal with people who are in their first three years of a psychotic illness | The client group |
| The EIS should integrate child/adolescent and adult mental health services | The client group |
| The EIS should have access to separate age-appropriate facilities for young people | The client group |
| The EIS should focus on people under the age of 35 years | The client group |
| The EIS should adhere to the principles of Assertive Community Treatment | Team structure |
| The EIS should promote peer support and self help initiatives | Team structure |
| The EIS should include a social worker | Membership |
| The EIS should include an occupational therapist | Membership |
| The EIS should include a support worker | Membership |
| The EIS should include at least one representative from CAMHS | Membership |
| The EIS should include a specialist in vocational rehabilitation | Membership |
| In the early phases of a psychotic illness the EIS should adopt a "watch and wait" brief | Initial assessment |
| Each EIS client should receive an early assessment of educational/vocational functioning | Initial assessment |
| EIS care plans should be reviewed every 6 months | Initial assessment |
| The EIS should routinely assess clients for substance misuse | Initial assessment |
| EIS should assign key workers on suspicion of psychosis but discharge if not psychotic | Initial assessment |
| The EIS should work with clients in the prodromal phase of psychosis | Initial assessment |
| The EIS should encourage direct referrals from services for young people | Initial assessment |
| Where possible the EIS should assess clients at home or in primary care | engagement |
| Where possible the EIS should treat clients at home or in primary care | engagement |
| The EIS should maintain contact with the client and family for 3 years after acceptance | engagement |
| The EIS should have a range of venues for assessment and treatment | engagement |
| The EIS should have an emphasis on finding employment or resuming work | Non-pharmaceutical |
| EIS should assess and treat symptoms of post-traumatic stress disorder | Non-pharmaceutical |
| The EIS should provide CBT to clients with disabling negative symptoms | Non-pharmaceutical |
| The EIS should include therapists trained and accredited in providing CBT for psychosis | Non-pharmaceutical |
| The EIS should have formal links with local colleges, careers advisory services & VR agencies | Non-pharmaceutical |
| Each client should have access to a vocational/educational training programme | Non-pharmaceutical |
| The EIS should be able to provide psychological interventions for substance misuse | Non-pharmaceutical |
| EIS should provide psychological interventions for anxiety/social phobias/avoidance | Non-pharmaceutical |
| The EIS should help clients develop daily living skills, where appropriate | Non-pharmaceutical |
| The EIS should include health promotion as part of its psycho-education package | Non-pharmaceutical |
| EIS should treat prodromal symptoms symptoms with CBT even when diagnosis uncertain | Non-pharmaceutical |
| EIS should regularly monitor medication side-effects using standardised monitoring tools | Pharmaceutical |
| EIS should involve the service user in monitoring the side-effects of drug treatment | Pharmaceutical |
| EIS should treat psychotic prodromal symptoms with drugs, even when diagnosis uncertain | Pharmaceutical |
| EIS should be persistent in treating residual positive symptoms with drug treatments | Pharmaceutical |
| Clients with positive symptoms not responding to other treatments should have clozapine trial | Pharmaceutical |
| Clients with positive symptoms 6 weeks after acute episode should have review drug treatment | Pharmaceutical |
| The EIS should offer clients the choice of pharmacological treatment | Pharmaceutical |
| EIS should attempt to maintain/establish contact between young clients & other young people | Relatives and sig others |
| The EIS should make initial contact with the client's family within one week of referral | Relatives and sig others |
| Initial contact with family should include "debriefing session", with opportunity to air feelings | Relatives and sig others |
| EIS should include therapists trained & accredited in Psychoeducational Family Interventions | Relatives and sig others |
| EIS should have access to age-appropriate crisis resolution facilities (non-inpatient crisis beds) | Admission to Hospital |
| When client requires acute care joint assessment should take place between EIS & acute team | Admission to Hospital |
| When client is in-patient, the EIS consultant should be responsible for his/her care | Admission to Hospital |
| EIS should be involved in community based programmes to reduce stigma of mental illness | Community links |
| EIS should provide symptom awareness programmes for relevant agencies | Community links |
| The EIS should provide clients with information about local service user groups | Community links |
| The EIS should ensure that the primary care team remain closely involved in client's treatment | Community links |
| The EIS should actively promote the use of community facilities | Community links |
| The EIS should foster close collaboration with youth organisations | Community links |
| EIS should have strategy for engaging the local community, based on needs and demography | Community links |