Protocol based assessment and management of First Episode Psychosis: Warwick- India-Canada (WIC) Global Mental Health Group (GMHG) on psychosis outcomes

Patients with first episode psychoses (FEP) have better chances of recovery compared to schizophrenia. Early stages of psychoses are critical in predicting its course and intervention early in the course of illness is important. Outcome of FEP can be improved by intervening early in the course of the illness. The implementation of early treatment for first episode and untreated psychosis is key to reducing the burden of disability due to psychotic disorders. However, the complexity of the Indian healthcare system and differences in cultural context means that simple ‘transplantation’ of western interventions is virtually impossible. Early intervention services focus specifically on reducing the duration of untreated psychosis (DUP), enhancing therapeutic engagement, and improving clinical and social outcomes by providing care in community-based, low-stigma settings. UK and Canada have led the development of early interventions in psychosis nationally and internationally. Combining the expertise from the UK, Canada and India, the Warwick-India-Canada (WIC) Project aimed to improve the health, wellbeing and functioning, and reduce the burden for those with psychotic disorders in India. The focus was tailoring evidence-informed interventions to the Indian socio-cultural context to: 1) transform the outcomes of psychotic disorders; 2) provide high quality research evidence for clinicians and policy makers; and 3) build research capacity, including new methodologies such as economic evaluation and implementation science. As part of the WIC project, two clinical sites – All India Institute of Medical Sciences (AIIMS), New Delhi and Schizophrenia Research Foundation (SCARF), Chennai used common assessment and outcome measures and standard management protocol for patients with FEP. By using validated and reliable assessment and outcomes measures, we planned cross-country and cross- setting comparisons and provide information to develop culturally appropriate, accessible, and acceptable interventions, which can be robustly tested for clinical and economic effectiveness, to improve psychosis outcomes in India and other LMIC. In this symposium, we share assessment and management protocol used for the FEP, their results and implications in two centres in India Background of the WIC study: SPS Study Protocol for First Episode Psychosis: RT Comparison of two centers: MS Implications of the study: RKC