1. Early Detection and Access

• Training programme for GPs and other key agencies in early detection
  
  
• Written guidance provided to GPs describing how to access services
  
  
• Regular contact in low stigma setting following referral
  
  
• Alternative strategies adopted before compulsory admission

2. Early and Sustained Engagement

• Allocation of community based key worker within 24 hours of referral
  
  
• Home or low stigma settings predominate in contact with client
  
  
• Sustained and planned engagement for three years before options considered
  
  
• No clients ‘lost to follow-up’, unless planned
  
  
• Failure to engage in treatment does not lead to case closure
  
  
  

3. Collaborative Needs Assessment

• Multidisciplinary contribution to assessment
  
  
• Client contribution to assessment
  
  
• Statement of needs, including symptoms, psychological and social needs



• Care plan updated every six months

4. Treatment

• Use of low-dose or atypical neuroleptics as first time options
  
  
• ‘Streaming’ of clients with early psychosis in separate inpatient accommodation
  
  
• Use of CBT with psychotic symptoms

5. Family Approach

• Carers involved in assessment process
  
  
• Provision of psycho-education for family/friends
  
  
• At least monthly contact with family

6. Relapse Prevention

• Early warning signs plan developed and on file
  
  
• Relapse prevention plan agreed with client
  
  
• Involvement of family

7. Education and Personal Recovery

• Psycho-education provided to client
  
  
• Early vocational assessment and training plan
  
  
• Availability of vocational recovery infrastructure (links with Further Education Colleges etc.)
  
  
• Availability of recovery groups to include recovered clients

8. The Basics

• Care plan addresses: housing, leisure, and income

9. Comorbidity

• Assessment of substance misuse
  
  
• Ongoing assessment of depression, hopelessness and suicidal thinking
  
  
• Assessment of PTSD reaction to psychosis at six months
  
  
• Use of CBT and recovery groups to promote adaptation to psychosis

10. Stigma Campaign

• Presence of local strategy
  
  
• Implementation through primary care, local media, schools and colleges