Dr Stephen Parker is confident the SURE-STEP Program which has been boosted by Foundation funding will have a hugely positive impact for patients and the health system.
PA Research Foundation funding is set to have a hugely positive impact on both the health of people with mental illness and the health system as whole.
The Foundation recently awarded psychiatrist Dr Stephen Parker with funding to progress the SURE-STEP Program which seeks address substance use in patients who have experienced psychosis for the first time.
Dr Parker is confident the program, which aims to design and establish a care pathway for psychosis patients, is likely to lessen the burden on mental health services by introducing a care model that will hopefully reduce presentations and admissions.
“One of the things that we don't that we know really clearly is that when someone has psychosis for the first time, that addressing their substance use problems is one of the most powerful ways to alter the trajectory of what might be a lifelong illness for them,” he said.
“Two of the substances that are critical are cannabis and amphetamines and helping people if they're using those substances to stop can increase the likelihood of them not going on to develop a chronic mental illness and the disability that often comes alongside that as well.
“The SURE-STEP program seeks to understand how to do better in terms of our everyday work. How do we pick up the substance use problems that people have? And then how do we start to have conversations in a better way to address that with them.”
Dr Parker detailed how the program is multifaceted and multidisciplinary in its conception and design and now, thanks to the Foundation’s donors can move forward.
“What's come together in that program is a group of people, including clinicians from mental health, people with alcohol and other drugs experience, as well as lived experience to think about how to improve our assessment and engagement processes…,” Dr Parker explained.
“There's a couple of components in that program of work. The first one is called SUNRISE, and that's about identifying substance use and working out, what's the level of unmet need for young people experiencing the first episode of psychosis in terms of substance use issues.
"Moving on from that we are interviewing people better understand what might enable or present barriers to people talking about the substance use with clinicians.
"The longer-term goal is to generate and co-design an evidence-based pathway of care that specifically addresses the needs of people experiencing the first episode of psychosis and concurrent substance use issues. We need to work out the best ways to identify these issues, and then how to best work with people to overcome them.”
"Moving on from that we are interviewing people better understand what might enable or present barriers to people talking about the substance use with clinicians.
"The longer-term goal is to generate and co-design an evidence-based pathway of care that specifically addresses the needs of people experiencing the first episode of psychosis and concurrent substance use issues. We need to work out the best ways to identify these issues, and then how to best work with people to overcome them.”
Once the pathway becomes common practice in mental health departments around the state, the team is confident it will reduce lifelong debilitating mental illness and give the patients much better quality of life.
“It's about supporting recovery for people presenting with psychosis for the first time, increasing the likelihood that this is a single event that people get better from and don't have lifelong symptoms and disability. Part of how you best do that, if substances have been there at the same time, is addressing that substance use because recovering from the substance use will help recovery from the psychosis as well,” he said.
“One of the things that happens at the first episode of psychosis is we often do not know what to call the problem, is this a drug-induced psychosis? Is this schizophrenia? Is this bipolar disorder? There are a whole range of things that could be going on and we need to take action to increase the likelihood of someone getting better and not becoming unwell again.
“Serious mental illness, like schizophrenia and bipolar disorder account for a massive proportion of the societal costs associated with mental illness. The recovery that you achieve in that first two years after the first episode tends to predict what someone's life will look like in 30 years’ time.
"So, if people are much better, one to two years after that first presentation, there's a good likelihood they're going to stay better.
"So, if people are much better, one to two years after that first presentation, there's a good likelihood they're going to stay better.
“When you look at people with a diagnosis like schizophrenia, they die 15 to 25 years younger than your average person, most of that is related not to the mental illness, it's related to physical health issues that come along with that as well.”
