New Zealand has 12 "early intervention services" which treat teens and young people suffering hallucinations, delusions or other symptoms, within the first two years of onset. Photo: Unsplash / Traveler Geek
- Age restrictions mean some people ineligible for help
- Some regions - particularly rural ones - have no early intervention service
- Lack of resourcing means just one of the 12 services is meeting benchmark of seeing 80 percent of patients before they are hospitalised.
Too many people are ending up in psychiatric wards with acute psychotic symptoms because they miss out on help at an early stage, new research has found.
New Zealand has 12 "early intervention services", which treat teenagers and young people suffering hallucinations, delusions or other symptoms, within the first two years of onset.
Results of a survey of these services between 2022 and 2024, have just been published in the international journal, Early Intervention in Psychiatry.
Lead author Dr Rebecca Grattan, a psychology lecturer at Victoria University, said just one service was meeting the international best practice standard of seeing 80 percent of people before hospitalisation.
"The services are really good, they've got a lot of good things going for them. But clinicians are reporting they're feeling very stretched, and there are not enough resources to meet the demand from everyone needing their services," she said.
The study found most services restricted access by setting age limits for treatment, leaving some people ineligible to get care.
"The lower end of the age range varied from 13 to 18 years and the upper end from 25 to 30 years. While younger people are more at risk of psychosis, people in older age groups can also experience symptoms.
"Age restrictions mean there will be at-risk people who won't be eligible to receive care."
Nationwide, nine districts had no early intervention service, although one offered "early psychosis care", with a dedicated nurse.
"This [gap] is more likely to affect people living in rural areas, including rural areas with a high Māori population, which are not well-served.
"People in those areas are getting more unwell and need to move to get care. Some of the connections between services are also lacking."
For example, the Bay of Plenty (approximate population of 309 000, of which 29 percent are Māori) has no early psychosis service
Patients 'bounced around' services
The problem was "lack of resources", Grattan said.
"They are so overwhelmed that each mental health service is having to limit and be quite specific about who they take.
"So they suggest that person goes somewhere, but that service is also quite overwhelmed.
"So what happens is that people end up getting bounced around and end up getting more unwell in the interim."
Early intervention in psychosis was proven to have much better outcomes for patients, which translated into huge savings for the health system long-term, she said.
"People think of schizophrenia or psychosis as being this very serious, disabling, chronic condition - but there is a spectrum of experience."
Some people have an isolated episode and recover. For others, their symptoms are so minor that they just continue to live their lives without problems.
"But we know that if people present with symptoms early on and nothing is done, some will get worse.
"We can easily see which people are going to need support and if we intervene then, they will have much better outcomes."
Heath NZ concedes there's room for improvement
Health NZ said it acknowledged the findings of the study, including the conclusion that services in New Zealand were "relatively comparable" to international services.
Head of mental health and addiction services, Dr Leanne Fisher, said timely access to early intervention psychosis services was "crucial to support people's recovery".
"We also recognise that there are areas for improvement in eligibility, cultural services and wider availability of therapy and family involvement.
"In line with the government's mental health targets, we are committed to faster access to specialist mental health and addiction services while growing the workforce and ensuring investment in prevention and early intervention."
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