Early intervention (EI) is the single most important advance in mental health care in recent decades, representing a key shift in both theoretical standpoint and service delivery.

Early Intervention in Psychiatry clearly describes best practice for extending this approach to all psychiatric disorders. Beginning with the rationale for EI, it informs interventions in people from all age groups across the lifespan, from perinatal to old age. It addresses EI in specific settings, such as primary health care, community health, the general hospital, non-government agencies, and in social movements, and for specific disorders including depression and anxiety, alcohol and substance use, childhood disorders, psychoses, bipolar disorders, eating disorders and borderline personality disorders.

Early Intervention in Psychiatry is an essential guide for all psychiatrists, general practitioners, family physicians and public health doctors. It is also a valuable resource for mental health professionals and primary care colleagues, including nurses, social workers, psychologists, occupational therapists, vocational rehabilitation specialists, peer and support workers and for mental health commissioners and policy-makers.

Peter Byrne, Homerton University Hospital, London; Royal College of Psychiatrists, UK

Alan Rosen, School of Public Health, University of Wollongong; Brain and Mind Research Institute, University of Sydney; Mental Health Commission of New South Wales, Australia

List of Contributors ix

Foreword xiii

Part I The Rationale for Early Intervention in Nearly Everything

1 Introduction 3
Peter Byrne and Alan Rosen

2 How Early Intervention Can Turn Things Upside Down and Turn a Patient Into a Psychiatrist 10
Nick Meinhold

3 Involving the Family in Early Interventions 20
Grainne Fadden

4 Do Early Intervention Services for Psychosis Represent Value for Money? 33
Paul McCrone and Martin Knapp

Part II Early Intervention Across the Lifespan

5 Perinatal Preventive Interventions in Psychiatry: A Clinical Perspective 45
Martin St-Andre, Hannah Schwartz and Keiko Yoshida

6 Psychiatry and Intervention in Infancy and Early Childhood 57
Jane Barlow

7 Early Intervention for Young People with Mental Illness 68
Tom Callaly

8 Transiting Out of Child and Adolescent Mental Health Services Influences on Continuities and Discontinuities in Mental Health Care 79
Linda Dowdney and Helen Bruce

9 Adults of Working Age 92
Karl Marlowe

10 Early Intervention in Older Adults A Focus on Alzheimers Dementia 103
Brian Lawlor and Celia OHare

Part III Early Intervention in Specific Settings

11 Primary Prevention of Mental Disorders 119
Inge Petersen, Arvin Bhana, Crick Lund and Helen Herrman

12 Early Intervention in Mental Health Problems: The Role of the Voluntary Sector 134
Andrew McCulloch, Isabella Goldie and Sophie Bridger

13 Why Primary Care Matters for Early Intervention in Psychiatry 147
David Shiers and Helen Lester

14 Early Intervention in the General Hospital 160
Peter Byrne and Iyas Assalman

15 Early Intervention Services versus Generic Community Mental Health Services: A Paradigm Shift 169
Marco Armando, Franco De Crescenzo and Maximilian Birchwood

Part IV Early Intervention in Specific Disorders

16 Prevention and Early Intervention in Depression and Anxiety Disorders 187
Irwin Nazareth and Tony Kendrick

17 Alcohol and Substance Use Prevention and Early Intervention 201
Nicola C. Newton, Mark Deady and Maree Teesson

18 Early Intervention in Childhood Disorders 218
Rajeev Jairam and Garry Walter

19 Early Intervention for Delirium 234
David Meagher and Walter Cullen

20 Early Intervention for Self-Harm and Suicidality 255
Sarah Steeg, Jayne Cooper and Nav Kapur

21 Early Intervention in Bipolar Disorder 267
Paddy Power, Philippe Conus, Craig Macneil and Jan Scott

22 Early Intervention in Eating Disorders 288
Leora Pinhas, Jennifer Wong and D. Blake Woodside

23 Early Intervention to Reduce Violence and Offending Outcomes in Young People with Mental Disorders 305
Rick Fraser, Rosemary Purcell and Danny Sullivan

24 Early Intervention for Borderline Personality Disorder 318
Andrew M. Chanen and Louise McCutcheon

Part V Conclusions

25 Early Intervention and the Power of Social Movements: UK Development of Early Intervention in Psychosis as a Social Movement and its Implications for Leadership 337
David Shiers and Jo Smith

26 Challenging Stigma 358
Amy C. Watson, Patrick Corrigan and Kristin Kosyluk

27 Conclusion: Towards Standards for Early Prevention and Intervention of Nearly Everything for Better Mental Health Services 373
Alan Rosen and Peter Byrne

Afterword for Early Intervention of Nearly Everything for Better Mental Health Services 396
Patrick McGorry

Index 400