Early Psychosis Intervention: A Culturally Adaptive Clinical Guide

Foreword

An adage of modern medicine states that early detection and treatment of a disorder is the key to achieving better outcomes. However, this concept has arrived rather belatedly in mental health. The understanding that psychoses afflict much suffering on both individuals and their families, and exact an enormous toll in social and economic costs from lost productivity also needs little emphasis. The possibility that these losses could be ameliorated by knowledge which we already have makes the situation even more tragic. Fortunately, in the past two decades, much hard work has been done and much gain has been achieved in the fight to alleviate distress and impairments in those experiencing psychosis. Notably, there are now many early detection and intervention programmes in UK, Europe, North America, and Asia. The earliest of such programmes in Asia started in Hong Kong and Singapore almost simultaneously. Both have in successive years grown in strength, emerged as leading centres in the region, and contributed significantly to the field. There are now programmes in South Korea and Japan too. But much still remains to be done in the world’s largest and most populous continents, such as China and Africa, where there are still many countries and regions that do not even have the rudiments of such infrastructures. The development and implementation of such programmes are similar world-wide, and yet dissimilar; each country having unique challenges and different variables including the amount of resources available, the level of priority allocated to mental health by local policy-makers, and the cultural values and attitudes of the general population towards mental disorders. Despite these differences, much can be learnt from the experiences of these programmes. What is implicitly evident from the chapters contained within this volume is that the leaders of these programmes have adopted a Foreword Siow Ann Chong xviii Foreword “leap-frogging” approach that delivers best outcomes. They have done this by learning and adapting best practices from each other and from around the world, and through integration and innovation. This would be one of the valuable lessons for those who read this book. The chapters represent a distillation of knowledge of thoughtful practitioners and researchers whose collective experiences have been forged from many years of frontline work, and undoubtedly from lessons learnt through mistakes made. The dialogue offers perspectives on how to make services accessible to patients and their families, how to establish links in the community, how to engage the public, how to deliver culturally sensitive interventions, and how to set up a database for evaluation and research. The latter contribution is important as there is “no such thing as a free lunch”. These wise, pragmatic practitioners know they need to show a return for policy-makers’ investments in these programmes, as well as counter critics and detractors. This book will be a useful resource for mental health professionals and for policy-makers involved in mental health, as well as residents in psychiatry and trainees in other mental health professions. As information and ideas covered in this book are not generally available, this volume will stimulate readers and will be a springboard for greater proactivity in this on-going fight for people suffering from psychosis. Siow Ann Chong Institute of Mental Health, Singapore ...