Which sociodemographic, clinical, and pathway to care factors influence
the wait time for early intervention for psychosis? A mental health
electronic health records analysis in South London
Abstract
Aim: In 2016, the Access and Waiting Time Standard (AWTS) was
introduced in England, UK, outlining that people with first-episode
psychosis should receive treatment from an early intervention for
psychosis (EIP) service within two weeks. We examined sociodemographic,
pathways to care (PtC), and clinical factors associated with EIP service
wait time. Method: We collected de-identified data from a large
mental health provider in South London, UK. We included patients
referred and accepted to EIP services as inpatient or community contacts
between 1st May 2016 and 30th April 2019, providing 3 years of data from
the introduction of AWTS. Descriptive statistics and multivariable
linear regression were performed. Results: A total of 1806
patients were identified with a mean age of 30 (SD:10.7) years, of whom
86.3% (n=1559) accessed community EIP and 13.7% (n=247) accessed
inpatient EIP; of these, 26.7% were not seen within 2 weeks. Community
EIP patients waited longer adj.β =2.21 days (95% CI: 2.05 – 2.37)
compared with inpatient EIP patients, and being older was associated
with longer wait time. Conversely, a shorter wait time was associated
with A&E [adj.β = -0.22 days (95% CI: -0.36, -0.10)] and ‘other’
[adj.β = -0.21 days (95% CI: -0.36, -0.03)] PtC. White non-British
and South Asian patients had shorter wait times compared with White
British patients; however, this difference diminished after adjusting
for PtC and clinical factors. Conclusions: Our findings
indicate that individual factors, PtC, and mode of contact influence
wait time for EIP services. More than a quarter of patients were not
seen within 2 weeks, indicating that targeted support in community EIP
services is needed to meet clinical guidelines.