Five of the ten leading causes of disability-adjusted life-years in young people are mental illnesses, of which psychotic disorders, such as schizophrenia, are the most severe and functionally disabling.
In June 2019, the Health Service Executive (HSE) launched a National Clinical Programme for Early Intervention in Psychosis, which places a strong emphasis on identifying young people at elevated risk of psychosis before illness onset, in order to apply preventive interventions.
The principal approach currently used to identify individuals at elevated risk of psychosis involves young people with subclinical psychotic symptoms presenting to dedicated ‘at risk mental state’ clinics. However, recent research shows that this approach identifies only a very small proportion of psychosis cases. It is clear, therefore, that if we are to realise the potential of psychosis prevention set out in the National Clinical Programme, we need new, higher capacity strategies to identify more individuals at risk of psychosis.
Longitudinal research has shown that people who develop psychosis have higher rates of many different childhood problems, including emotional, interpersonal, language, cognitive and motor impairments. Importantly, these are all problems that can lead to referral to child and adolescent mental health services (CAMHS). Therefore, although psychosis is uncommon in childhood, risk for future psychosis might be elevated in children who attend CAMHS.
This study will use large population datasets to identify the relationship between CAMHS contact and risk for psychosis. It will (1) identify the proportion of psychosis cases preceded by CAMHS contact, (2) determine the absolute risk of psychotic disorders among CAMHS attenders, (3) create a clinical risk calculator for determining risk of psychosis among CAMHS patients, (4) investigate medications that may impact psychosis risk and (5) produce an information resource for young people with, or at risk of, psychosis, co-designed by service users and family members.
