Table 4.
Acute care and clinical outcomes
| Implementation site | Comparator site | |||||||||
| Baseline | Year 1 | Year 2 | P value | P value | Baseline | Year 1 | Year 2 | P value | P value | |
| (n=69) | (n=118) | (n=124) | Y1 vs baseline | Y2 vs baseline | (n=145) | (n=168) | (n=102) | Y1 vs baseline | Y2 vs baseline | |
| Acute MH admission within 1 year of EIP referral | 27 (39%) | 47 (40%) | 36 (29%) | 0.16 | 16 (11%) | 21 (13%) | 19 (19%) | 0.20 | ||
| Time to acute admission (where applicable) (weeks) |
0.0 (0.0 to 10.0) | 1.0 (0.0 to 7.0) | 0.0 (0.0 to 3.5) | 0.88 | 0.11 | 15.0 (3.0 to 41.0) | 11.0 (2.0 to 41.0) | 13.5 (3.0 to 34.0) | 0.82 | 0.92 |
| Time to acute MH/inpatient screening (hours) | ||||||||||
| 0–4 | 21 (91%) | 1 (100%) | 14 (67%) | – | 11 (73%) | 11 (58%) | 8 (53%) | 0.49 | ||
| 4–6 | 0 (0%) | 0 (0%) | 6 (29%) | 3 (20%) | 4 (21%) | 3 (20%) | ||||
| 6–8 | 1 (4%) | 0 (0%) | 0 (0%) | 0 (0%) | 2 (11%) | 1 (7%) | ||||
| 8–10 | 1 (4%) | 0 (0%) | 1 (5%) | 1 (7%) | 2 (11%) | 3 (20%) | ||||
| Time from acute admission to discharge (where applicable weeks) | 4.5 (2.0 to 10.3) | 4.0 (2.0 to 6.8) | 3.0 (1.0 to 5.3) | 0.42 | 0.56 | 3.0 (2.0 to 13.5) | 3.0 (2.0 to 5.0) | 3.0 (2.3 to 3.8) | 0.56 | 0.95 |
| Number of subsequent acute admissions | ||||||||||
| None | 18 (64%) | 41 (85%) | 25 (71%) | 0.091 | 14 (67%) | 15 (65%) | 13 (62%) | 0.95 | ||
| 1 | 6 (21%) | 4 (8%) | 9 (26%) | 5 (24%) | 2 (9%) | 8 (38%) | ||||
| More than 1 | 4 (14%) | 3 (6%) | 1 (3%) | 2 (10%) | 6 (26%) | 0 (0%) | ||||
| MHA section within 1 year of EIP referral | 25 (36%) | 39 (33%) | 34 (27%) | 0.58 | 16 (11%) | 21 (13%) | 18 (18%) | 0.18 | ||
| Contact acute MH services (post EIP) | 32 (46%) | 41 (35%) | 37 (30%) | <0.0001 | 25 (17%) | 30 (18%) | 22 (22%) | <0.0001 | ||
| Crisis plan completed | 35 (51%) | 59 (50%) | 44 (35%) | 0.032 | 71 (49%) | 69 (41%) | 68 (67%) | 0.00023 | ||
| Time to crisis plan completed (weeks) | 50.0 (15.0 to 79.0) | 22.5 (10.0 to 37.8) | 12.5 (6.0 to 22.8) | 0.0010 | <0.0001 | 8.0 (1.0 to 23.0) | 11.0 (1.0 to 39.0) | 12.0 (2.0 to 34.3) | 0.36 | 0.10 |
| A&E attendance within 1 year of EIP referral | 7 (10%) | 10 (8%) | 11 (9%) | 0.91 | 11 (8%) | 12 (7%) | 10 (10%) | 0.72 | ||
| Time to A&E attendance (weeks) | 21.0 (2.5 to 68.3) | 8.5 (0.0 to 17.0) | 13.0 (8.0 to 43.0) | 0.15 | 0.88 | 30.0 (25.0 to 41.0) | 44.0 (11.0 to 76.0) | 14.5 (7.3 to 31.5) | 0.87 | 0.11 |
| Reason for A&E attendance | ||||||||||
| Deterioration in mental state | 7 (41%) | 7 (50%) | 5 (42%) | – | 2 (15%) | 4 (24%) | 2 (20%) | – | ||
| Self harm/suicidal ideation/suicide attempt/overdose | 6 (35%) | 5 (36%) | 4 (33%) | 10 (77%) | 6 (35%) | 4 (40%) | ||||
| Alcohol/substance abuse | 1 (6%) | 1 (7%) | 2 (17%) | 0 (0%) | 1 (6%) | 0 (0%) | ||||
| Medication side effects | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 1 (6%) | 1 (10%) | ||||
| Physical injury/illness (not apparently psychosis related) | 3 (18%) | 1 (7%) | 1 (8%) | 1 (8%) | 5 (29%) | 3 (30%) | ||||
| General hospital admission within 1 year of EIP referral | 1 (1%) | 4 (3%) | 3 (2%) | – | 2 (1%) | 0 (0%) | 4 (4%) | – | ||
| Contact with criminal justice system while in EIP pathway | 15 (22%) | 34 (29%) | 4 (3%) | <0.0001 | 20 (14%) | 20 (12%) | 21 (21%) | <0.0001 | ||
| Criminal conviction within 1 year of EIP referral | 1 (1%) | 0 (0%) | 0 (0%) | – | 4 (3%) | 4 (2%) | 1 (1%) | – | ||
| Deaths within 1 year of EIP referral | 0 (0%) | 0 (0%) | 0 (0%) | – | 0 (0%) | 0 (0%) | 1 (1%) | – | ||
Proportion of individuals accepted onto the EIP pathway at each trust experiencing acute care outcomes (n (%)) within 1 year of trust referral, and time to reach those outcomes, where applicable (median (IQR)). Excludes EIP to EIP transfers. P values for categorical comparisons from χ2 test or Fisher's exact test as appropriate. P values for continuous data from Mann-Whitney U tests.
EIP, early intervention in psychosis; MH, mental health; MHA, Mental Health Act.