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 if detected early and treated rigorously. 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. The study found substantial improvement on various outcome measures including functioning and family burden. The results offer scope of further application of the management protocol on a larger scale in low- and middle-income countries. In this symposium, the presenters will discuss the background of the study, protocols of assessment and interventions, compare findings at two centres and implications of the findings. Background of the WIC study: Swaran Preet Singh, university of Warwick, UK Study Protocol for First Episode Psychosis: R Thara, SCARF India, Chennai Comparison of two centres: Mamta Sood, AIIMS, New Delhi Comorbidity and Physical Activity Intervention: R Padmavati, SCARF India, Chennai Implications of the study: Rakesh K Chadda, AIIMS, New Delhi