Table 1.
Program characteristics of EIS in Quebec in 2020
|
All programs
(total n = 28) |
Programs founded before 2017
(total n = 17) |
Programs founded from 2017 and onwards
(total n = 11) |
||
|---|---|---|---|---|
| Program characteristics | ||||
| Access to hospital beds | Youth-friendly unit, specific to EIS a | 1/28 | 1/17 | 0/11 |
| Regular unit in which EIS a patients are grouped, followed by EIS a psychiatrist | 3/28 | 2/17 | 1/11 | |
| Regular unit in which EIS a patients are grouped, followed by any inpatient psychiatrist | 3/28 | 3/17 | 0/11 | |
| Regular unit in which EIS a patients are not grouped, followed by EIS a psychiatrist | 7/28 | 3/17 | 4/11 | |
| Regular unit in which EIS a patients are not grouped, followed by any inpatient psychiatrist | 12/28 | 6/17 | 6/11 | |
| No access to hospital beds | 2/28 | 2/17 | 0/11 | |
| Accessibility and early detection targets | ||||
| Screening assessment | Maximum delay is set by program | 19/28 | 10/17 | 9/11 |
| Targeted maximum delay in days Median (range) |
3.0 (2-14) | 3.0 (2-14) | 3.0 (2-3) | |
| Psychiatric assessment | Maximum delay is set by program | 19/28 | 10/17 | 9/11 |
| Targeted maximum delay in days Median (range) |
14.0 (2-30) | 14.0 (2-30) | 14.0 (3-15) | |
| Time from referral to program entry | Maximum delay is set by program | 16/28 | 8/17 | 8/11 |
| Targeted maximum delay in days Median (range) |
14.0 (3-30) | 14.0 (3-30) | 7.0 (3-15) | |
| Early detection interventions | Public education | 4/28 | 4/17 | 0/11 |
| Referral sources education | 26/28 | 15/17 | 11/11 | |
| Admission criteria | ||||
| Lower age limit (excluding exclusive child and adolescent psychiatric programs) |
≤ 12 y.o. a | 14/25 | 6/14 | 8/11 |
| 14-17 y.o. a | 6/25 | 3/14 | 2/11 | |
| 18 y.o. a | 5/25 | 4/14 | 1/11 | |
| Higher age limit (excluding exclusive child and adolescent psychiatric programs) |
< 35 y.o. a | 7/25 | 7/14 | 0/11 |
| ≥ 35 y.o. a | 18/25 | 7/14 | 11/11 | |
| Services | ||||
| Targeted maximum length of follow-up in the program | 2 years | 3/28 | 2/17 | 1/11 |
| 3 years | 13/28 | 6/17 | 7/11 | |
| 4-5 years | 6/28 | 5/17 | 1/11 | |
| No maximum duration | 6/28 | 4/17 | 2/11 | |
| Services for UHR-P b | Formal UHR-P b clinic | 6/28 | 5/17 | 1/11 |
| Follow-up offered to UHR-P b patients without formal specific program | 8/28 | 6/17 | 2/11 | |
| Standardised care tools | Protocol for metabolic monitoring | 19/28 | 11/17 | 8/11 |
| Maximising engagement | ||||
| Discharge criteria | Maximum program duration completed | 22/28 | 13/17 | 9/11 |
| Remitted from positive symptoms (even if patient hasn't reached the maximum time allowed in the program) | 10/28 | 5/17 | 5/11 | |
| Patient ceased follow-up, felt better | 17/28 | 11/17 | 6/11 | |
| Patient refusal of treatment | 12/28 | 8/17 | 4/11 | |
| Noncompliance to pharmacological or nonpharmacological interventions | 0/28 | 0/17 | 0/11 | |
| Failure to keep appointments | 4/28 | 2/17 | 2/11 | |
| Others† | 10/28 | 7/17 | 3/11 | |
| Assertive outreach targeting patients who fail to keep appointments or are noncompliant to treatment | Yes | 28/28 | 17/17 | 11/11 |
| Program statistics | ||||
| Average length of follow-up in the program | 1-2 years | 15/28 | 7/17 | 8/11 |
| 3 years | 11/28 | 8/17 | 3/11 | |
| 4-5 years | 2/28 | 2/17 | 0/11 | |
| Average number of referrals per year (last 3 years) | Mean | 67.4 | 76.7 | 53.1 |
| Median (range) | 60 (2-200) | 60 (20-200) | 47 (2-130) | |
| Average number of admitted first-episode psychosis (FEP) patients per year (last 3 years) | Mean | 47.9 | 51.2 | 42.8 |
| Median (range) | 40 (2-150) | 40 (15-150) | 38 (2-80) | |
| Access to timely screening assessments | 80% of patients contacted within 72h of referral | 10/21 | 7/14 | 3/7 |
| Access to timely psychiatric evaluation | 80% of patients assessed within 2 weeks of referral | 16/24 | 9/15 | 7/9 |
| Average time from referral to program
entry (days) |
Mean | 10.5 | 12.6 | 7.3 |
| Median (range) | 7.5 (1-45) | 10.0 (2-45) | 7.0 (1-15) | |
| Proportion of time spent on outreach activities | 0-10% | 2/27 | 1/16 | 1/11 |
| 11-20% | 5/27 | 5/16 | 0/11 | |
| 21-30% | 3/27 | 3/16 | 0/11 | |
| 31-40% | 6/27 | 6/16 | 0/11 | |
| > 40% | 17/27 | 7/16 | 10/11 | |
| Patient to case manager ratios | < 15:1 | 7/26 | 5/15 | 2/11 |
| 15-19:1 | 11/26 | 4/15 | 7/11 | |
| 20:1-24:1 | 6/26 | 4/15 | 2/11 | |
| > 25:1 | 2/26 | 2/15 | 0/11 | |
Total n reported for individual outcomes may differ from the total number of programs, due to missing data (programs who did not answer the question or reported unavailable data).
a
: y.o.: Years old
b
: UHR-P: Ultra-high risk for psychosis
†: Other discharge criteria included patients wrongly admitted to the EIS (n = 1/10), patients whose needs are better fulfilled by other mental health services (n = 3/10; e.g., assertive community treatment), patients who moved outside the catchment area (n = 1/10) or whose whereabouts are untraceable (n = 1/10), and patients who completed their recovery goals (n = 1/10). The 3 child and adolescent psychiatry programs noted that reaching age 18 was a discharge criterion.